Provider Demographics
NPI:1811795685
Name:CENTRAL MISSOURI PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:CENTRAL MISSOURI PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KARLEE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SHETTLESWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:573-999-0863
Mailing Address - Street 1:303 N KEENE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-8050
Mailing Address - Country:US
Mailing Address - Phone:573-449-8771
Mailing Address - Fax:
Practice Address - Street 1:303 N KEENE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8050
Practice Address - Country:US
Practice Address - Phone:573-449-8771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty