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General NPI Number Information
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NPI Number | 1982193611
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Entity Type | Individual
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Provider Name | MRS. AILEEN ABISTADO HUGHES
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Gender | Female
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Dates
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Enumeration Date | 05/08/2018
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Last Update Date | 05/08/2018
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Provider Practice Location Address
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Address Line | 7733 FORSYTH BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63105-1817
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Country | US
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Telephone | 314-659-2110
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Fax | 855-864-2718
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Provider Business Mailing Address
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Address Line | 16605 ROUTE 84 N
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City | EAST MOLINE
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State | IL
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Zip | 61244-9771
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Country | US
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Telephone | 563-249-3272
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Fax | 888-896-0301
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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 | 070021323
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License Number State | IL
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