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General NPI Number Information
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NPI Number | 1861057960
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Entity Type | Organization
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Legal Business Name | SPRINGER PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 05/03/2019
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Last Update Date | 05/03/2019
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Provider Practice Location Address
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Address Line | 1630 MARKET CENTER DR STE 202
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City | O FALLON
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State | MO
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Zip | 63368-8407
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Country | US
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Telephone | 636-263-3006
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Fax | 636-263-3007
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Provider Business Mailing Address
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Address Line | 14515 N OUTER 40 RD STE 112
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City | CHESTERFIELD
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State | MO
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Zip | 63017-5746
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Country | US
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Telephone | 636-263-3006
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Fax | 636-263-3007
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Authorized Official
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Title or Position | CEO / PT
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Name | LISA JO SPRINGER
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Credential | PT, DPT, CMPT
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Telephone | 636-263-3006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number |
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License Number State |
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