Healthcare Provider Details

I. General information

NPI: 1578619730
Provider Name (Legal Business Name): MARY L CURRAN P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9822 CHESTERTON DR
SAINT LOUIS MO
63123-6412
US

IV. Provider business mailing address

9822 CHESTERTON DR
SAINT LOUIS MO
63123-6412
US

V. Phone/Fax

Practice location:
  • Phone: 314-631-9646
  • Fax:
Mailing address:
  • Phone: 314-631-9646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number00664
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: