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General NPI Number Information
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NPI Number | 1629022256
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Entity Type | Organization
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Legal Business Name | FENTON PHYSICAL THERAPY
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 400 BILTMORE DR SUITE 403
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City | FENTON
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State | MO
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Zip | 63026-4641
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Country | US
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Telephone | 636-343-0350
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Fax | 636-343-3519
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Provider Business Mailing Address
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Address Line | 400 BILTMORE DR SUITE 403
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City | FENTON
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State | MO
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Zip | 63026-4641
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Country | US
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Telephone | 636-343-0350
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Fax | 636-343-3519
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Authorized Official
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Title or Position | DIRECTOR OF CLINIC AND P.T.
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Name | MR. GARY E. MEIER
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Credential | P.T.
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Telephone | 636-343-0350
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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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