Healthcare Provider Details

I. General information

NPI: 1881540193
Provider Name (Legal Business Name): MATCHFIT PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

806 BROWNELL AVE
SAINT LOUIS MO
63122-3237
US

IV. Provider business mailing address

806 BROWNELL AVE
SAINT LOUIS MO
63122-3237
US

V. Phone/Fax

Practice location:
  • Phone: 224-330-5189
  • 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: DR. DANIEL JAMES ROSS
Title or Position: PHYSICAL THERAPIST
Credential: PT,DPT
Phone: 224-330-5189