Healthcare Provider Details

I. General information

NPI: 1477117356
Provider Name (Legal Business Name): KATHERINE CRIPPIN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2019
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2937 S BRENTWOOD BLVD
SAINT LOUIS MO
63144-2713
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 314-961-3804
  • Fax: 314-961-1147
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2023019203
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: