Organization Name: | PREMIER PHYSICAL THERAPY |
NPI Number: | 1700943438 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTINE WALTERS (ADMINISTRATOR) |
Mailing Address: | 1032 Old Des Peres Rd Des Peres |
State: | MO US |
Postal Code: | 631311865 |
Phone Number: | 3148216181 |
Fax Number: | 3148216184 |
NPI Enumeration Date: | 01/02/2007 |
NPI Last Update Date: | 07/27/2007 |
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: |