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NPI Code Detail

MEDICARE: AT HOME PHYSICAL THERAPY, LLC

MEDICARE: AT HOME PHYSICAL THERAPY, 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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1477791838
Entity Type Code : Organization
Provider Name (Legal Business Name) : AT HOME PHYSICAL THERAPY, LLC
Provider Business Mailing Address
First Line : 34 HILLSIDE MANOR COURT
Second Line :
City : ST. PETERS
State : MO
Zip : 63376-4144
Country : US
Telephone Number : 314-922-6844
Fax Number : 636-294-9500
Provider Business Practice Location Address
First Line : 34 HILLSIDE MANOR COURT
Second Line :
City : ST. PETERS
State : MO
Zip : 63376-4144
Country : US
Telephone Number : 314-922-6844
Fax Number : 636-294-9500
Authorized Official
Title or Position : OWNER
Name : SCOTT GUTSHALL
Credential : P.T.
Telephone Number : 314-922-6844
Provider Enumeration Date : 01/23/2009
Last Update Date : 10/29/2009

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Directions to “AT HOME PHYSICAL THERAPY, LLC ” Practice Location

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