Provider Demographics
NPI:1750555322
Name:NEWBY, DENISE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:NEWBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 VIVARON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-4217
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:636-255-0844
Practice Address - Street 1:283 VIVARON AVE
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-4217
Practice Address - Country:US
Practice Address - Phone:314-302-7252
Practice Address - Fax:636-255-0844
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist