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General NPI Number Information
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NPI Number | 1700191897
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Entity Type | Individual
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Provider Name | DARCY BOATRIGHT P.T.
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Gender | Female
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Dates
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Enumeration Date | 08/12/2010
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Last Update Date | 08/12/2010
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Provider Practice Location Address
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Address Line | 600 MEDICAL DR SUITE 109
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City | WENTZVILLE
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State | MO
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Zip | 63385-3426
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Country | US
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Telephone | 636-327-1170
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Fax | 636-327-1174
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Provider Business Mailing Address
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Address Line | 1816 HEATHER GLEN CT
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City | LAKE SAINT LOUIS
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State | MO
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Zip | 63367-4246
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Country | US
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Telephone | 636-327-0939
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Fax | 636-327-0939
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2005001372
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License Number State | MO
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