Healthcare Provider Details

I. General information

NPI: 1093854580
Provider Name (Legal Business Name): ORTHOMOTION L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

763 S NEW BALLAS RD SUITE 370
SAINT LOUIS MO
63141-8704
US

IV. Provider business mailing address

763 S NEW BALLAS RD SUITE 370
SAINT LOUIS MO
63141-8704
US

V. Phone/Fax

Practice location:
  • Phone: 314-994-7400
  • Fax: 314-994-7401
Mailing address:
  • Phone: 314-994-7400
  • Fax: 314-994-7401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberLC0071981
License Number StateMO

VIII. Authorized Official

Name: MRS. LADONNA APPELBAUM
Title or Position: PRINCIPAL
Credential:
Phone: 314-994-7400