Provider Demographics
NPI:1326588856
Name:OPTIONS IN PYHSICAL THERAPY
Entity Type:Organization
Organization Name:OPTIONS IN PYHSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:EVERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-749-9599
Mailing Address - Street 1:5026 GLENNON DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-4328
Mailing Address - Country:US
Mailing Address - Phone:314-749-9599
Mailing Address - Fax:
Practice Address - Street 1:777 S NEW BALLAS RD
Practice Address - Street 2:SUITE 218E
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8705
Practice Address - Country:US
Practice Address - Phone:314-749-9599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy