Healthcare Provider Details

I. General information

NPI: 1437997749
Provider Name (Legal Business Name): CK THERAPIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2024
Last Update Date: 07/19/2024
Certification Date: 07/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11298 KIMMEL LAKE RD
SAINTE GENEVIEVE MO
63670-8625
US

IV. Provider business mailing address

4796 CYPRESS POINTE DR
IMPERIAL MO
63052-2152
US

V. Phone/Fax

Practice location:
  • Phone: 573-984-0104
  • Fax:
Mailing address:
  • Phone: 314-800-6260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JAMIE CALDWELL
Title or Position: OWNER
Credential:
Phone: 314-800-6260