Healthcare Provider Details

I. General information

NPI: 1457945156
Provider Name (Legal Business Name): MEREDITH P CROSIER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2021
Last Update Date: 02/23/2021
Certification Date: 02/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 WATERBURY FALLS DR
O FALLON MO
63368-2202
US

IV. Provider business mailing address

2122 YORK RD STE 300
OAK BROOK IL
60523-1925
US

V. Phone/Fax

Practice location:
  • Phone: 636-336-0300
  • Fax: 636-336-0297
Mailing address:
  • Phone: 630-575-1980
  • Fax: 630-928-5080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2021004480
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: