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General NPI Number Information
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NPI Number | 1093045940
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Entity Type | Individual
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Provider Name | JENNIFER K REZABEK MPT
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Gender | Female
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Dates
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Enumeration Date | 12/28/2009
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Last Update Date | 02/10/2016
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Provider Practice Location Address
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Address Line | 134 CHESTERFIELD VALLEY DRIVE
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City | CHESTERFIELD
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State | MO
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Zip | 63005-1161
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Country | US
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Telephone | 636-812-0094
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Fax | 636-812-0152
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Provider Business Mailing Address
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Address Line | 15 APEX DR SUITE 105
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City | HIGHLAND
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State | IL
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Zip | 62249-1282
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Country | US
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Telephone | 618-441-0482
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Fax | 618-441-0482
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2009037275
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License Number State | MO
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