Alisa Noel Blackketter, P.T.A.

NPI #1427479294 in Hillsboro, Kansas

Provider Information

NPI Number: 1427479294
Entity Type: Individual
Name: Alisa Noel Blackketter, P.T.A.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Credential: P.T.A.
Enumeration Date: Dec 22, 2013
Last Updated: Dec 22, 2013

Practice Location

Address: 201 S CEDAR ST
City: Hillsboro
State: Kansas
ZIP Code: 67063-1311
Phone: (620) 877-0588

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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