Healthcare Provider Details

I. General information

NPI: 1396008975
Provider Name (Legal Business Name): ARLEEN B STRYSHAK PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2012
Last Update Date: 06/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5943 TELEGRAPH RD
SAINT LOUIS MO
63129-4715
US

IV. Provider business mailing address

373 EDGAR RD
SAINT LOUIS MO
63119-4235
US

V. Phone/Fax

Practice location:
  • Phone: 314-375-1025
  • Fax:
Mailing address:
  • Phone: 314-963-7404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number112528
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: