Healthcare Provider Details

I. General information

NPI: 1164481909
Provider Name (Legal Business Name): GLENDA JANE ALFIER PT, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 08/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 MEXICO RD SUITE 104
SAINT PETERS MO
63376-1666
US

IV. Provider business mailing address

2454 W CLAY ST
SAINT CHARLES MO
63301-2548
US

V. Phone/Fax

Practice location:
  • Phone: 636-939-9540
  • Fax: 636-939-9886
Mailing address:
  • Phone: 636-916-4625
  • Fax: 636-916-4628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2004022969
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2251H1200X
TaxonomyHand Physical Therapist
License Number2004022969
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: