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General NPI Number Information
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NPI Number | 1023569084
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Entity Type | Organization
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Legal Business Name | ATR TONY LLC
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Dates
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Enumeration Date | 10/14/2016
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Last Update Date | 10/14/2016
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Provider Practice Location Address
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Address Line | 1229 WENTZVILLE PKWY SUITE 209
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City | WENTZVILLE
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State | MO
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Zip | 63385-3552
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Country | US
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Telephone | 314-453-9997
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Fax |
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Provider Business Mailing Address
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Address Line | 14515 NORTH OUTER 40 RD SUITE 110
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City | CHESTERFIELD
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State | MO
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Zip | 63017-5791
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JAMES S HOFMAN
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Credential |
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Telephone | 314-434-8680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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