| NPI | 1295899722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN GORDON Vice President 314-644-1978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 105413) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 102882) |
| 225100000X Physical Therapist (Licence: MO 2005040574) | |
| 225100000X Physical Therapist (Licence: MO R0877) | |
| 225100000X Physical Therapist (Licence: MO 02232) | |
| 225100000X Physical Therapist (Licence: MO 2006032824) | |
| 225X00000X Occupational Therapist (Licence: MO 002775) | |
| 235Z00000X Speech-Language Pathologist, (Licence: MO 2004006992) | |
| 235Z00000X Speech-Language Pathologist, (Licence: IL 146.007307) | |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2024-02-07 |