Healthcare Provider Details

I. General information

NPI: 1851621890
Provider Name (Legal Business Name): FALL PREVENTION NETWORKS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2010
Last Update Date: 05/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 S NEW BALLAS RD 005
SAINT LOUIS MO
63141-8705
US

IV. Provider business mailing address

777 S NEW BALLAS RD 005
SAINT LOUIS MO
63141-8705
US

V. Phone/Fax

Practice location:
  • Phone: 314-238-6901
  • Fax: 314-743-2005
Mailing address:
  • Phone: 314-238-6901
  • Fax: 314-743-2005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. TYLER RAASCH
Title or Position: PRESIDENT
Credential:
Phone: 314-328-6901