Healthcare Provider Details

I. General information

NPI: 1962313643
Provider Name (Legal Business Name): UNIFIED PT AND YOGA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7930 BIG BEND BLVD STE C
SAINT LOUIS MO
63119-2786
US

IV. Provider business mailing address

21 WINGFIELD RD
SAINT LOUIS MO
63122-1919
US

V. Phone/Fax

Practice location:
  • Phone: 636-626-0227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. SAMANTHA JO SPIEGEL
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 314-792-9052