| NPI | 1467907436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL PATRICK TUCKEY President 314-265-7616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO RO567) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.002146) |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2016-08-19 |