Provider First Line Business Practice Location Address:
650 MARYVILLE UNIVERSITY DR
Provider Second Line Business Practice Location Address:
PHYSICAL THERAPY PROGRAM
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63141-5849
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-529-9257
Provider Business Practice Location Address Fax Number:
314-529-9495
Provider Enumeration Date:
08/09/2009