Healthcare Provider Details

I. General information

NPI: 1891306072
Provider Name (Legal Business Name): KATHLEEN M SPREHE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN ANDERSON DPT

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4044 BUTLER HILL RD
SAINT LOUIS MO
63129-1500
US

IV. Provider business mailing address

14515 N OUTER 40 RD
CHESTERFIELD MO
63017-5791
US

V. Phone/Fax

Practice location:
  • Phone: 314-487-6644
  • Fax:
Mailing address:
  • Phone: 314-434-8680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2020025697
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: