| Organization Name: | CRESCENT PHYSICAL REHABILITATION, LLC |
| NPI Number: | 1154595122 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SIKANDER M BAJWA (PRESIDENT) |
| Mailing Address: | 1519 Virginia Dr Ellisville |
| State: | MO US |
| Postal Code: | 630112046 |
| Phone Number: | 3146161276 |
| Fax Number: | |
| NPI Enumeration Date: | 04/21/2008 |
| NPI Last Update Date: | 04/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | LC0531406 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |