MEDICARE: DAVID BATSON MPT

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	:	1568975647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID BATSON MPT

Provider Business Mailing Address
First Line	:	4401 PARKER RD
Second Line	:
City	:	BLACK JACK
State	:	MO
Zip	:	63033-4266
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4401 PARKER RD
Second Line	:
City	:	BLACK JACK
State	:	MO
Zip	:	63033-4266
Country	:	US
Telephone Number	:	314-355-1516
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2017
Last Update Date	:	11/10/2017

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Directions to “ DAVID BATSON MPT” Practice Location

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