| NPI | 1528740214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER PATRICE RIESMEYER Owner 314-504-3995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2023-08-02 |
| Last Update Date | 2024-05-03 |