| The Fountains Of West County | |
|
15822 Clayton Rd Ellisville MO 63011-2212 | |
| (636) 220-1681 | |
| (314) 200-4636 |
| Full Name | The Fountains Of West County |
|---|---|
| Speciality | Clinic/center |
| Location | 15822 Clayton Rd, Ellisville, Missouri |
| Authorized Official Name and Position | Kelly Ann Fiala (OT/REHAB DIRECTOR) |
| Authorized Official Contact | 6364482881 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Fountains Of West County 15822 Clayton Rd Ellisville MO 63011-2212 Ph: (636) 220-1681 | The Fountains Of West County 15822 Clayton Rd Ellisville MO 63011-2212 Ph: (636) 220-1681 |
| NPI Number | 1699131573 |
|---|---|
| Provider Enumeration Date | 01/08/2016 |
| Last Update Date | 01/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699131573 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2005028265 (Missouri) | Primary |
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