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General NPI Number Information
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NPI Number | 1851258743
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Entity Type | Organization
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Legal Business Name | INNOVATIVE THERAPY INITIATIVE
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 1310 PAPIN ST STE 109
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City | SAINT LOUIS
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State | MO
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Zip | 63103-3132
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Country | US
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Telephone | 314-690-9995
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Fax | 314-558-2600
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Provider Business Mailing Address
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Address Line | 1310 PAPIN ST STE 109
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City | SAINT LOUIS
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State | MO
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Zip | 63103-3132
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Country | US
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Telephone | 314-503-1203
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Fax | 314-558-2600
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MR. GARY A SEEMAN
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Credential |
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Telephone | 314-690-9995
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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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