Healthcare Provider Details

I. General information

NPI: 1619526001
Provider Name (Legal Business Name): RICHARD PATRICK KERN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1428 W MEYER RD
WENTZVILLE MO
63385-3499
US

IV. Provider business mailing address

4 ARNOLD MALL
ARNOLD MO
63010-2223
US

V. Phone/Fax

Practice location:
  • Phone: 636-887-3660
  • Fax: 636-887-3661
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2017025338
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: