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General NPI Number Information
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NPI Number | 1477791838
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Entity Type | Organization
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Legal Business Name | AT HOME PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 01/23/2009
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Last Update Date | 10/29/2009
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Provider Practice Location Address
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Address Line | 34 HILLSIDE MANOR COURT
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City | ST. PETERS
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State | MO
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Zip | 63376-4144
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Country | US
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Telephone | 314-922-6844
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Fax | 636-294-9500
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Provider Business Mailing Address
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Address Line | 34 HILLSIDE MANOR COURT
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City | ST. PETERS
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State | MO
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Zip | 63376-4144
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Country | US
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Telephone | 314-922-6844
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Fax | 636-294-9500
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT GUTSHALL
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Credential | P.T.
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Telephone | 314-922-6844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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