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NPI Code Detail

MEDICARE: ANTHONY EGIZI PHYSICAL THERAPIST

MEDICARE: ANTHONY EGIZI PHYSICAL THERAPIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1588853907
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY EGIZI PHYSICAL THERAPIST
Provider Business Mailing Address
First Line : 15 APEX DR
Second Line :
City : HIGHLAND
State : IL
Zip : 62249-1282
Country : US
Telephone Number : 618-441-0482
Fax Number :
Provider Business Practice Location Address
First Line : 5203 CHIPPEWA ST 200
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63109-2356
Country : US
Telephone Number : 314-732-1553
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2007
Last Update Date : 07/07/2015

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Directions to “ ANTHONY EGIZI PHYSICAL THERAPIST” Practice Location

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