Provider Demographics
NPI:1053630244
Name:CASE, JAMIE LYNN (PT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:CASE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:LYNN
Other - Last Name:REICHERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3301 BERRYWOOD DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-6517
Mailing Address - Country:US
Mailing Address - Phone:573-449-6082
Mailing Address - Fax:573-449-0401
Practice Address - Street 1:941 CHEROKEE DR
Practice Address - Street 2:SUITE 2A
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340-3646
Practice Address - Country:US
Practice Address - Phone:660-831-1895
Practice Address - Fax:660-831-1898
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010015650225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist