Provider Demographics
NPI:1205950318
Name:JAMES, BETH C (MPT, CHT)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:C
Last Name:JAMES
Suffix:
Gender:F
Credentials:MPT, CHT
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:R
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13537 BARRETT PARKWAY DR
Mailing Address - Street 2:PRO REHAB SUITE 105
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021
Mailing Address - Country:US
Mailing Address - Phone:314-821-9126
Mailing Address - Fax:314-821-9142
Practice Address - Street 1:221 SPENCER RD
Practice Address - Street 2:PRO REHAB SUITE D
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376
Practice Address - Country:US
Practice Address - Phone:636-447-9911
Practice Address - Fax:636-477-9929
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001026571225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO223171511Medicare PIN
MO223171509Medicare PIN