Healthcare Provider Details

I. General information

NPI: 1023962958
Provider Name (Legal Business Name): PRIDE REHAB & PERFORMANCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 S KINGSHIGHWAY BLVD
SAINT LOUIS MO
63110-2108
US

IV. Provider business mailing address

1530 S KINGSHIGHWAY BLVD
SAINT LOUIS MO
63110-2228
US

V. Phone/Fax

Practice location:
  • Phone: 314-750-2253
  • Fax:
Mailing address:
  • Phone: 314-750-2253
  • Fax: 314-689-5881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CURTIS WELDON
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 314-750-2253