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General NPI Number Information
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NPI Number | 1710966528
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Entity Type | Organization
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Legal Business Name | WEST PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 675 OLD BALLAS RD SUITE 210
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City | SAINT LOUIS
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State | MO
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Zip | 63141-7083
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Country | US
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Telephone | 314-994-7468
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Fax | 314-994-3725
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Provider Business Mailing Address
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Address Line | PO BOX 411040
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City | SAINT LOUIS
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State | MO
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Zip | 63141-3040
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Country | US
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Telephone | 314-994-7468
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Fax | 314-994-3725
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. DAVID SCOTT OVERBY
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Credential | MHS, PT, OCS
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Telephone | 314-994-7468
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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 | 02198
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License Number State | MO
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