Provider Demographics
NPI:1356017982
Name:SINAK, MARISSA ANNE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MARISSA
Middle Name:ANNE
Last Name:SINAK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 BELLEVUE AVE STE 15
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1851
Mailing Address - Country:US
Mailing Address - Phone:314-768-5375
Mailing Address - Fax:314-768-5376
Practice Address - Street 1:1027 BELLEVUE AVE STE 15
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1851
Practice Address - Country:US
Practice Address - Phone:314-768-5375
Practice Address - Fax:314-768-5376
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021033718225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist