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NPI Code Detail

MEDICARE: DENISE NEWBY

MEDICARE:   DENISE  NEWBY
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
1172M00000XMechanotherapist

General Provider Information

NPI Number : 1750555322
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE NEWBY
Provider Business Mailing Address
First Line : 283 VIVARON AVE
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63303-4217
Country : US
Telephone Number :
Fax Number : 636-255-0844
Provider Business Practice Location Address
First Line : 283 VIVARON AVE
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63303-4217
Country : US
Telephone Number : 314-302-7252
Fax Number : 636-255-0844
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2008
Last Update Date : 04/15/2008

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Directions to “ DENISE NEWBY ” Practice Location

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