Provider Demographics
NPI:1730389461
Name:ARMBRUSTER, MICHELLE (PTA)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:ARMBRUSTER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:GAMACHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:4850 LEMAY FERRY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-1576
Mailing Address - Country:US
Mailing Address - Phone:314-892-6048
Mailing Address - Fax:314-487-3062
Practice Address - Street 1:845 N NEW BALLAS CT
Practice Address - Street 2:SUITE 40
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7134
Practice Address - Country:US
Practice Address - Phone:314-872-1644
Practice Address - Fax:314-872-1801
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO116679225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant