MEDICARE: JS INDUSTRIES, INC.

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
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1679738983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JS INDUSTRIES, INC.

Provider Business Mailing Address
First Line	:	230 FORT ZUMWALT SQ
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63366-3064
Country	:	US
Telephone Number	:	636-379-7506
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 FORT ZUMWALT SQ
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63366-3064
Country	:	US
Telephone Number	:	636-379-7506
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. JOHN JOSEPH SHEEHAN III
Credential	:	ATC/L
Telephone Number	:	636-379-7506

Provider Enumeration Date	:	07/25/2008
Last Update Date	:	07/25/2008

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Directions to “JS INDUSTRIES, INC. ” Practice Location

Language	Start Address	Practice Location

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