Provider Demographics
NPI:1164681813
Name:HARTNETT, ALICE G (MPT)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:G
Last Name:HARTNETT
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:
Other - Last Name:ALTEPETER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:127 HIGHGROVE LN
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-7113
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:127 HIGHGROVE LN
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-7113
Practice Address - Country:US
Practice Address - Phone:314-497-2077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-07
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 23888225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist