Healthcare Provider Details

I. General information

NPI: 1588503353
Provider Name (Legal Business Name): PARKER SEACHRIST DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5114 MID AMERICA PLZ
SAINT LOUIS MO
63129-0003
US

IV. Provider business mailing address

912 LONGFELLOW AVE
EDWARDSVILLE IL
62025-2336
US

V. Phone/Fax

Practice location:
  • Phone: 314-305-2728
  • Fax:
Mailing address:
  • Phone: 314-305-2728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number2025020252
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number070.039730
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: