Provider Demographics
NPI:1215330162
Name:BARNETT, CASSIE C (PT)
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:C
Last Name:BARNETT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63902-0003
Mailing Address - Country:US
Mailing Address - Phone:573-712-2280
Mailing Address - Fax:573-778-9589
Practice Address - Street 1:2981 KANELL BLVD
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-4008
Practice Address - Country:US
Practice Address - Phone:573-712-2280
Practice Address - Fax:573-778-9589
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014026862225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist