Provider Demographics
NPI:1710966528
Name:WEST PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:WEST PHYSICAL THERAPY, LLC
Other - Org Name:HANDS ON THERAPEUTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:OVERBY
Authorized Official - Suffix:
Authorized Official - Credentials:MHS, PT, OCS
Authorized Official - Phone:314-994-7468
Mailing Address - Street 1:PO BOX 411040
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-3040
Mailing Address - Country:US
Mailing Address - Phone:314-994-7468
Mailing Address - Fax:314-994-3725
Practice Address - Street 1:675 OLD BALLAS RD
Practice Address - Street 2:SUITE 210
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7083
Practice Address - Country:US
Practice Address - Phone:314-994-7468
Practice Address - Fax:314-994-3725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO02198225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO559769OtherHEALTHLINK
MO110165OtherBLUE CROSS BLUE SHIELD
MO431782915OVEOtherMERCY
MO607604600OtherWC/DOL/OWCP
MO5677756OtherFIRST HEALTH
MO6400160OtherUNITED HEALTH CARE
MO7617001OtherAETNA
MO9147944OtherPRIVATE HEALTH CARE SYSTE
MO607604600OtherWC/DOL/OWCP
MO431782915OVEOtherMERCY
MO7617001OtherAETNA