Provider Demographics
NPI:1255929121
Name:KILGORE, DANA (PT)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:KILGORE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:3488 JEFFCO BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-6015
Mailing Address - Country:US
Mailing Address - Phone:636-464-5439
Mailing Address - Fax:636-464-5438
Practice Address - Street 1:3488 JEFFCO BLVD STE 102
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MO
Practice Address - Zip Code:63010-6015
Practice Address - Country:US
Practice Address - Phone:636-464-5439
Practice Address - Fax:636-464-5438
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics