| NPI | 1154445369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL THOMAS CIBULKA Owner 636-931-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: MO 00947) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2014-09-30 |