Healthcare Provider Details

I. General information

NPI: 1952136079
Provider Name (Legal Business Name): JULIA MARIE LAPPE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S KIRKWOOD RD
SAINT LOUIS MO
63122-7254
US

IV. Provider business mailing address

12767 HONEYGROVE CT
SAINT LOUIS MO
63146-4405
US

V. Phone/Fax

Practice location:
  • Phone: 314-821-7554
  • Fax:
Mailing address:
  • Phone: 314-698-9558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2024036550
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: