Provider Demographics
NPI:1982117354
Name:KREHBIEL, SADDIE (ATC)
Entity Type:Individual
Prefix:
First Name:SADDIE
Middle Name:
Last Name:KREHBIEL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62234-2327
Mailing Address - Country:US
Mailing Address - Phone:618-610-7646
Mailing Address - Fax:
Practice Address - Street 1:6800 WYDOWN BLVD
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-3043
Practice Address - Country:US
Practice Address - Phone:314-249-5740
Practice Address - Fax:314-249-5740
Is Sole Proprietor?:No
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170260612255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer