MEDICARE: JEFFREY J HUNTER 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
1	225100000X	Physical Therapist	113820	MO

General Provider Information

NPI Number	:	1871747196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY J HUNTER PT

Provider Business Mailing Address
First Line	:	1348 BASS PRO DR
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63301-2461
Country	:	US
Telephone Number	:	630-575-1980
Fax Number	:	314-821-9142

Provider Business Practice Location Address
First Line	:	1832 WENTZVILLE PKWY
Second Line	:
City	:	WENTZVILLE
State	:	MO
Zip	:	63385-3817
Country	:	US
Telephone Number	:	636-327-7110
Fax Number	:	636-327-7135

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

Provider Enumeration Date	:	11/13/2008
Last Update Date	:	08/16/2018

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