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NPI Code Detail

MEDICARE: DR. MARK OLMSTED PT, DPT

MEDICARE: DR. MARK OLMSTED PT, 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 Therapist2007028026MO

General Provider Information

NPI Number : 1841466752
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK OLMSTED PT, DPT
Provider Business Mailing Address
First Line : 11937 MANCHESTER RD
Second Line :
City : DES PERES
State : MO
Zip : 63131-4502
Country : US
Telephone Number : 314-822-4400
Fax Number : 314-822-4111
Provider Business Practice Location Address
First Line : 11937 MANCHESTER RD
Second Line :
City : DES PERES
State : MO
Zip : 63131-4502
Country : US
Telephone Number : 314-822-4400
Fax Number : 314-822-4111
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2008
Last Update Date : 05/01/2008

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Directions to “ DR. MARK OLMSTED PT, DPT” Practice Location

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