Provider Demographics
NPI:1144356551
Name:YEMM, JEAN M (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:M
Last Name:YEMM
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 N NEW BALLAS RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6713
Mailing Address - Country:US
Mailing Address - Phone:314-872-3345
Mailing Address - Fax:314-872-3180
Practice Address - Street 1:641 N NEW BALLAS RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6713
Practice Address - Country:US
Practice Address - Phone:314-872-3345
Practice Address - Fax:314-872-3180
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00758225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist