Healthcare Provider Details

I. General information

NPI: 1134172711
Provider Name (Legal Business Name): ANGELA RENEE DREXLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA RENEE HENRY

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14825 N OUTER 40 SUITE 300
CHESTERFIELD MO
63017-2026
US

IV. Provider business mailing address

13537 BARRETT PARKWAY DR SUTIE 105
BALLWIN MO
63021-5899
US

V. Phone/Fax

Practice location:
  • Phone: 636-812-1211
  • Fax: 636-812-0159
Mailing address:
  • Phone: 314-821-9126
  • Fax: 314-821-9142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2000148979
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: