| Organization Name: | NORTH COUNTY SPORTS FITNESS & REHABILITATION |
| NPI Number: | 1265562565 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BETTY BURKE (OFFICE MANAGER) |
| Mailing Address: | 6308 Hazelwest Ct Hazelwood |
| State: | MO US |
| Postal Code: | 630421739 |
| Phone Number: | 3148954664 |
| Fax Number: | 3147312340 |
| NPI Enumeration Date: | 03/06/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251S0007X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Sports |
| Taxonomy Definition: | |