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NPI Code Detail

MEDICARE: STEVEN REIERSON DPT

MEDICARE: STEVEN REIERSON DPT
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 TherapistPT-7981ID
2225100000XPhysical Therapist2022029652MO

General Provider Information

NPI Number : 1821723297
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN REIERSON DPT
Provider Business Mailing Address
First Line : 4273 KEATON CROSSING BLVD
Second Line :
City : O FALLON
State : MO
Zip : 63368-8220
Country : US
Telephone Number : 636-206-6540
Fax Number :
Provider Business Practice Location Address
First Line : 1348 BASS PRO DR
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63301-2461
Country : US
Telephone Number : 636-757-5075
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2022
Last Update Date : 07/28/2022

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