Provider First Line Business Practice Location Address:
1400 HWY 61 SOUTH
Provider Second Line Business Practice Location Address:
ATTN: ACUTE REHAB
Provider Business Practice Location Address City Name:
CRYSTAL CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
636-933-1558
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/11/2010