MEDICARE: ALLEN - HARMONY HEALTHCARE 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	01099	MO

General Provider Information

NPI Number	:	1528217502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEN - HARMONY HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	9139 RUSTICWOOD TRL
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63126-2213
Country	:	US
Telephone Number	:	314-849-7416
Fax Number	:

Provider Business Practice Location Address
First Line	:	11426 GRAVOIS RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63126-3656
Country	:	US
Telephone Number	:	314-369-0594
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TERRY ALLEN
Credential	:	PT
Telephone Number	:	314-849-7416

Provider Enumeration Date	:	09/15/2008
Last Update Date	:	09/15/2008

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