Provider Demographics
NPI:1689711392
Name:SCHLUETER, SHELLY A (P T)
Entity Type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:A
Last Name:SCHLUETER
Suffix:
Gender:F
Credentials:P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8600 GIRL SCOUT RD
Mailing Address - Street 2:
Mailing Address - City:PEVELY
Mailing Address - State:MO
Mailing Address - Zip Code:63070-1115
Mailing Address - Country:US
Mailing Address - Phone:636-479-7812
Mailing Address - Fax:636-479-7812
Practice Address - Street 1:10560 OLD OLIVE STREET RD
Practice Address - Street 2:SUITE #100
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-5916
Practice Address - Country:US
Practice Address - Phone:314-567-4707
Practice Address - Fax:314-567-4504
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO015112251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1114090792OtherGROUP NPI