Provider Demographics
NPI:1285844688
Name:MERCY ST JOHN'S
Entity Type:Organization
Organization Name:MERCY ST JOHN'S
Other - Org Name:ST JOHN'S THERAPY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:417-533-6315
Mailing Address - Street 1:247 EMERALD LOOP
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65706-9010
Mailing Address - Country:US
Mailing Address - Phone:417-859-4173
Mailing Address - Fax:
Practice Address - Street 1:331 HOSPITAL DR STE D
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:MO
Practice Address - Zip Code:65536-9251
Practice Address - Country:US
Practice Address - Phone:417-533-6315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO107422282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural