Dionneshae Monique Forland I PTA

NPI 1174752711 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1174752711
Gender Female
Enumeration Date 07/03/2009
Last Updated 06/18/2013
Entity Type Individual
Active Over 7 years ago
Practice Location
9191 W FLORISSANT AVE
SUITE 200
SAINT LOUIS MO, 63136-1424, US
Phone (314) 524-3958
Fax (314) 524-3959
Business Location
9191 W FLORISSANT AVE
SUITE 200
SAINT LOUIS MO, 63136-1424, US
Phone (314) 524-3958
Fax (314) 524-3959
Toxanomy
Taxonomy Code 225200000X
License State Missouri
License Number 117525
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According to our database, Dionneshae Monique Forland I PTA NPI is 1174752711, taxonomy code is 225200000X and license number is 117525, license state is located at Missouri. Dionneshae Monique Forland I PTA physically located at 9191 W Florissant Ave, Saint Louis MO, 63136-1424. NPI Number Dionneshae Monique Forland I PTA has the Individual type.

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1174752711 NPI number is provided on an as is basis without warranty of any kind. 1174752711 is maintained by the National Plan & Provider Enumeration System. The contents of Dionneshae Monique Forland I PTA are for informational purposes only.