Organization Name: | SSM SELECT REHAB ST LOUIS LLC |
NPI Number: | 1043450828 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL TARVIN (VICE PRESIDENT) |
Mailing Address: | 722 North Highway 47 Warrenton |
State: | MO US |
Postal Code: | 633831108 |
Phone Number: | 6364568883 |
Fax Number: | |
NPI Enumeration Date: | 03/06/2009 |
NPI Last Update Date: | 08/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |