Provider Demographics
NPI:1538642152
Name:INFINITY PHYSICAL THERAPY
Entity Type:Organization
Organization Name:INFINITY PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:NOIRFAL
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:314-814-1450
Mailing Address - Street 1:17363 EDISON AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-1250
Mailing Address - Country:US
Mailing Address - Phone:314-814-1450
Mailing Address - Fax:
Practice Address - Street 1:17363 EDISON AVE
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-1250
Practice Address - Country:US
Practice Address - Phone:314-814-1450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy