Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicole Brook Roach, PTA, LMT

Individual provider Physical Therapy Assistant · NPI 1275004210

Nicole Brook Roach, PTA, LMT is a Physical Therapy Assistant in Jefferson City, Missouri. Licensed in Missouri. Registered with an NPI since 2018.

Licensed in
MO
In the registry since
2018
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.
LMT — Licensed Massage Therapist
A state-licensed massage therapist.

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Practice location Address checks out

1720 Vieth Dr
Jefferson City, MO 65109-2056
Phone: (573) 635-6139
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 2018037409 (MO)

Record details

NPI number1275004210
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA , LMT
Sole proprietorNo
NPI enumeratedDecember 17, 2018
Last updated in NPPESDecember 17, 2018
Mailing address2223 Buehrle Dr, Jefferson City, MO 65109-1926

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