MEDICARE: PREMIER PHYSICAL THERAPY

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	:	1700943438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	1032 OLD DES PERES RD
Second Line	:
City	:	DES PERES
State	:	MO
Zip	:	63131-1865
Country	:	US
Telephone Number	:	314-821-6181
Fax Number	:	314-821-6184

Provider Business Practice Location Address
First Line	:	1032 OLD DES PERES RD
Second Line	:
City	:	DES PERES
State	:	MO
Zip	:	63131-1865
Country	:	US
Telephone Number	:	314-821-6181
Fax Number	:	314-821-6184

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. CHRISTINE WALTERS
Credential	:	PT
Telephone Number	:	314-821-6181

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	07/27/2007

Similar Medicare Providers

1194720037 — DR. THOMAS G JOHANS M.D.
Practice Location Address:

1070 OLD DES PERES RD
SAINT LOUIS, MO
63131-1865

Practice Phone: 636-386-9224
Practice Fax: 636-386-7679

1336144187 — DR. TODD D BAILEY M.D.
Practice Location Address:

1070 OLD DES PERES RD
SAINT LOUIS, MO
63131-1865

Practice Phone: 314-821-8644
Practice Fax: 314-821-4858

1659377687 — DR. STEPHEN D SCHMIDT M.D.
Practice Location Address:

1070 OLD DES PERES RD
SAINT LOUIS, MO
63131-1865

Practice Phone: 314-821-8644
Practice Fax: 314-821-4858

1386640316 — DR. GREGORY H SMITH D.O.
Practice Location Address:

1070 OLD DES PERES RD
SAINT LOUIS, MO
63131-1865

Practice Phone: 314-821-8644
Practice Fax: 314-821-4858

1588661417 — DR. JAMES EDWARD BENECKE JR. M.D., F.A.C.S.
Practice Location Address:

1010 OLD DES PERES RD
SAINT LOUIS, MO
63131-1865

Practice Phone: 314-729-0077
Practice Fax: 314-552-7308

1326049636 — MICHAEL P. NOGALSKI M.D.
Practice Location Address:

1050 OLD DES PERES RD. , SUITE 100
ST. LOUIS, MO
63131-1865

Practice Phone: 314-569-0612
Practice Fax: 314-966-0664

1871594184 — WILLIAM B. STRECKER M.D.
Practice Location Address:

1050 OLD DES PERES RD. , SUITE 100
ST. LOUIS, MO
63131-1865

Practice Phone: 314-569-0612
Practice Fax: 314-966-0664

Directions to “PREMIER PHYSICAL THERAPY ” Practice Location

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