Healthcare Provider Details

I. General information

NPI: 1407072531
Provider Name (Legal Business Name): ANITA H FRUMSON B.S.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4005 RIPA AVE
SAINT LOUIS MO
63125-2378
US

IV. Provider business mailing address

212 HEWLETT CT
SAINT LOUIS MO
63141-8153
US

V. Phone/Fax

Practice location:
  • Phone: 314-544-1111
  • Fax:
Mailing address:
  • Phone: 314-878-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number0085
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: