MEDICARE: BABAR ENTERPRISES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist		MO

General Provider Information

NPI Number	:	1154685162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BABAR ENTERPRISES LLC

Provider Business Mailing Address
First Line	:	2454 W CLAY ST
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63301-2548
Country	:	US
Telephone Number	:	636-916-4625
Fax Number	:	636-916-4625

Provider Business Practice Location Address
First Line	:	1346 CLARKSON CLAYTON CTR
Second Line	:
City	:	ELLISVILLE
State	:	MO
Zip	:	63011-2145
Country	:	US
Telephone Number	:	636-227-5200
Fax Number	:	636-227-5202

Authorized Official
Title or Position	:	OWNER / AUTHORIZED OFFICIAL
Name	:	STEVEN N DAVIDSON
Credential	:
Telephone Number	:	636-356-5000

Provider Enumeration Date	:	06/25/2012
Last Update Date	:	04/14/2014

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Directions to “BABAR ENTERPRISES LLC ” Practice Location

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