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NPI Code Detail

MEDICARE: PHYSICAL THERAPY CONSULTANTS, INC

MEDICARE: PHYSICAL THERAPY CONSULTANTS, INC
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 Therapist00394MO

General Provider Information

NPI Number : 1720028566
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICAL THERAPY CONSULTANTS, INC
Provider Business Mailing Address
First Line : 2865 NETHERTON DR
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63136-4674
Country : US
Telephone Number : 314-653-0918
Fax Number :
Provider Business Practice Location Address
First Line : 2865 NETHERTON DR
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63136-4674
Country : US
Telephone Number : 314-653-0918
Fax Number :
Authorized Official
Title or Position : OWNER
Name : GARY PEVNICK
Credential : PT
Telephone Number : 314-653-0918
Provider Enumeration Date : 06/08/2006
Last Update Date : 01/20/2015

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Directions to “PHYSICAL THERAPY CONSULTANTS, INC ” Practice Location

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