Healthcare Provider Details

I. General information

NPI: 1093963027
Provider Name (Legal Business Name): APRIL M BRUNE MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 09/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10859 W FLORISSANT AVE
SAINT LOUIS MO
63136-2405
US

IV. Provider business mailing address

10859 W FLORISSANT AVE
SAINT LOUIS MO
63136-2405
US

V. Phone/Fax

Practice location:
  • Phone: 314-521-3000
  • Fax: 314-521-7800
Mailing address:
  • Phone: 314-521-3000
  • Fax: 314-521-7800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2008011779
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: