| |
5960 Howdershell Road, Suite 204, Hazelwood, MO 63042 | |
(314) 895-1136 | |
(314) 895-5040 |
Full Name | |
---|---|
Type | Facility |
Speciality | Physical Medicine & Rehabilitation |
Location | 5960 Howdershell Road, Hazelwood, Missouri |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275512592 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 005778 (Missouri) | Primary |
111N00000X | Chiropractor | 005773 (Missouri) | Primary |
208100000X | Physical Medicine & Rehabilitation | 01795 (Missouri) | Primary |
Mailing Address | Practice Location Address |
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5960 Howdershell Road, Suite 204, Hazelwood, MO 63042 Ph: (314) 895-1136 | 5960 Howdershell Road, Suite 204, Hazelwood, MO 63042 Ph: (314) 895-1136 |