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NPI Code Detail

MEDICARE: BARBARA JEAN MAGRUDER PT

MEDICARE:   BARBARA JEAN MAGRUDER  PT
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
1225100000XPhysical Therapist0319MO

General Provider Information

NPI Number : 1538498225
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA JEAN MAGRUDER PT
Provider Business Mailing Address
First Line : 439 S KIRKWOOD RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63122-6169
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 439 S KIRKWOOD RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63122-6169
Country : US
Telephone Number : 314-822-6285
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2009
Last Update Date : 12/09/2009

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Directions to “ BARBARA JEAN MAGRUDER PT” Practice Location

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