Provider Demographics
NPI:1639131683
Name:BRIDGES, JEFFREY ALMON (MPT, ATC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:ALMON
Last Name:BRIDGES
Suffix:
Gender:M
Credentials:MPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 CHAPEL HILL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-5504
Mailing Address - Country:US
Mailing Address - Phone:573-446-4900
Mailing Address - Fax:573-447-3600
Practice Address - Street 1:1506 CHAPEL HILL RD
Practice Address - Street 2:SUITE A
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-5504
Practice Address - Country:US
Practice Address - Phone:573-446-4900
Practice Address - Fax:573-447-3600
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001028975225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOBCBS OF MISSOURIOther131417
MOGROUP HEALTH PLANOther109505
MOHEALTHLINKOther449897