Provider Demographics
NPI:1255499042
Name:DENT, THERESA ANN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:ANN
Last Name:DENT
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4377 WINDWARD
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:MO
Mailing Address - Zip Code:63461-2073
Mailing Address - Country:US
Mailing Address - Phone:573-769-5577
Mailing Address - Fax:
Practice Address - Street 1:6000 HOSPITAL DR. HIGHWAY 36 WEST
Practice Address - Street 2:REHABILITATION DEPARTMENT HANNIBAL REGIONAL HOSPITAL
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401
Practice Address - Country:US
Practice Address - Phone:573-248-5346
Practice Address - Fax:573-248-5364
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01292225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist