| NPI | 1558032540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA SHEPHERD Coordinator 314-315-5148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2021-09-21 |