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General NPI Number Information
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NPI Number | 1144839887
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Entity Type | Organization
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Legal Business Name | ATR JUSTIN LLC
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Dates
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Enumeration Date | 07/29/2020
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Last Update Date | 07/29/2020
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Provider Practice Location Address
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Address Line | 15882 CLAYTON RD
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City | ELLISVILLE
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State | MO
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Zip | 63011-2212
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Country | US
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Telephone | 314-434-8680
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Fax |
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Provider Business Mailing Address
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Address Line | 14515 NORTH OUTER 40 RD STE 110
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City | CHESTERFIELD
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State | MO
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Zip | 63017-5746
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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 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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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