Healthcare Provider Details

I. General information

NPI: 1306386172
Provider Name (Legal Business Name): HOUSEPT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2017
Last Update Date: 01/27/2022
Certification Date: 12/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3809 LEMAY FERRY RD
SAINT LOUIS MO
63125-4535
US

IV. Provider business mailing address

2806 FLAMEWOOD DR
SAINT LOUIS MO
63129-2526
US

V. Phone/Fax

Practice location:
  • Phone: 314-939-1377
  • Fax: 314-449-9173
Mailing address:
  • Phone: 314-941-2578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number2005015490
License Number StateMO

VIII. Authorized Official

Name: LIZBETH TEMPLIN
Title or Position: OWNER
Credential: PT, DPT, GCS
Phone: 314-941-2578