Provider Demographics
NPI:1477153062
Name:PHYSICAL THERAPY DIRECT
Entity Type:Organization
Organization Name:PHYSICAL THERAPY DIRECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:HU
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, DMT, FAAOMPT
Authorized Official - Phone:636-443-5020
Mailing Address - Street 1:25 TERRE VERTE CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-1217
Mailing Address - Country:US
Mailing Address - Phone:636-443-5020
Mailing Address - Fax:
Practice Address - Street 1:25 TERRE VERTE CT
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-1217
Practice Address - Country:US
Practice Address - Phone:636-443-5020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-01
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty