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General NPI Number Information
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NPI Number | 1679738983
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Entity Type | Organization
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Legal Business Name | JS INDUSTRIES, INC.
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Dates
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Enumeration Date | 07/25/2008
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Last Update Date | 07/25/2008
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Provider Practice Location Address
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Address Line | 230 FORT ZUMWALT SQ
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City | O FALLON
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State | MO
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Zip | 63366-3064
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Country | US
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Telephone | 636-379-7506
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Fax |
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Provider Business Mailing Address
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Address Line | 230 FORT ZUMWALT SQ
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City | O FALLON
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State | MO
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Zip | 63366-3064
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Country | US
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Telephone | 636-379-7506
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. JOHN JOSEPH SHEEHAN III
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Credential | ATC/L
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Telephone | 636-379-7506
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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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