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General NPI Number Information
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NPI Number | 1184534935
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Entity Type | Organization
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Legal Business Name | RESTORE 360 PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 09/11/2026
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Last Update Date | 09/11/2026
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Provider Practice Location Address
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Address Line | 1242 CLEARVIEW RD
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City | UNION
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State | MO
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Zip | 63084-3107
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Country | US
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Telephone | 636-628-2425
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Fax |
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Provider Business Mailing Address
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Address Line | 4825 DOOR FORD RD
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City | BEAUFORT
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State | MO
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Zip | 63013-1717
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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 | OWNER/ PHYSICAL THERAPIST
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Name | KRISTEN BRUEGGEMANN
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Credential | MPT
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Telephone | 314-623-5161
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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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