Provider Demographics
NPI:1861057960
Name:SPRINGER PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:SPRINGER PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / PT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:SPRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CMPT
Authorized Official - Phone:636-263-3006
Mailing Address - Street 1:14515 N OUTER 40 RD STE 112
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5746
Mailing Address - Country:US
Mailing Address - Phone:636-263-3006
Mailing Address - Fax:636-263-3007
Practice Address - Street 1:1630 MARKET CENTER DR STE 202
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-8407
Practice Address - Country:US
Practice Address - Phone:636-263-3006
Practice Address - Fax:636-263-3007
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPRINGER PHYSICAL THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty