Provider Demographics
NPI:1467651174
Name:SALTO, ARIEL (PT)
Entity Type:Individual
Prefix:MR
First Name:ARIEL
Middle Name:
Last Name:SALTO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4603 RIDGEWOOD AVE
Mailing Address - Street 2:APT 4
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63116-1427
Mailing Address - Country:US
Mailing Address - Phone:636-284-9880
Mailing Address - Fax:
Practice Address - Street 1:4603 RIDGEWOOD AVE
Practice Address - Street 2:APARTMENT 4
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63116-1427
Practice Address - Country:US
Practice Address - Phone:636-284-9880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006032826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist