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General NPI Number Information
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NPI Number | 1558979583
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Entity Type | Organization
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Legal Business Name | JUSTUPRIGHT THERAPY SERVICES
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 07/22/2020
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Provider Practice Location Address
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Address Line | 4977 SEIBERT AVE
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City | AFFTON
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State | MO
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Zip | 63123-4736
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Country | US
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Telephone | 314-287-0757
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Fax |
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Provider Business Mailing Address
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Address Line | 4977 SEIBERT AVE
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City | AFFTON
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State | MO
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Zip | 63123-4736
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Country | US
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Telephone | 314-287-0757
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GINALYN LACSON RUDER
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Credential | DPT
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Telephone | 314-287-0757
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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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