Provider Demographics
NPI:1902125123
Name:REDDY HEALTH AND PERFORMANCE INC
Entity Type:Organization
Organization Name:REDDY HEALTH AND PERFORMANCE INC
Other - Org Name:SAFE FITNESS SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-477-6520
Mailing Address - Street 1:1645 KEEVEN LN
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-6433
Mailing Address - Country:US
Mailing Address - Phone:314-477-6520
Mailing Address - Fax:
Practice Address - Street 1:1645 KEEVEN LN
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-6433
Practice Address - Country:US
Practice Address - Phone:314-477-6520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2010-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty