Provider Demographics
NPI:1811196983
Name:GROPPE, MICHELLE M (PTA)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:M
Last Name:GROPPE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 LEMAY FERRY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-1576
Mailing Address - Country:US
Mailing Address - Phone:314-892-6048
Mailing Address - Fax:314-487-3062
Practice Address - Street 1:12639 OLD TESSON RD
Practice Address - Street 2:SUITE 120
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2786
Practice Address - Country:US
Practice Address - Phone:314-842-3968
Practice Address - Fax:314-248-5236
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO116030225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant