Healthcare Provider Details

I. General information

NPI: 1164344693
Provider Name (Legal Business Name): SEMO PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2064B WALTON DR
JACKSON MO
63755-3701
US

IV. Provider business mailing address

2064B WALTON DR
JACKSON MO
63755-3701
US

V. Phone/Fax

Practice location:
  • Phone: 573-204-0429
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JULIE ANN LITZELFELNER
Title or Position: OWNER/CEO
Credential: MOT, OTR/L
Phone: 573-225-9424