Healthcare Provider Details
I. General information
NPI: 1295929644
Provider Name (Legal Business Name): APEX PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/29/2007
Last Update Date: 09/02/2021
Certification Date: 09/02/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
884 WOODS MILL RD STE 200
BALLWIN MO
63011-3657
US
IV. Provider business mailing address
15 APEX DR
HIGHLAND IL
62249-1282
US
V. Phone/Fax
- Phone: 636-238-4910
- Fax:
- Phone: 618-651-0444
- Fax: 618-654-5439
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QX0100X |
| Taxonomy | Occupational Medicine Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
BRADLEY
R
PFITZNER
Title or Position: CEO PRESIDENT
Credential: OTR L
Phone: 618-651-0444