# JOINT VENTURE REHABILITATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295970325
- **Authorized official:** SHAWN KELLY EVERSON PT, DPT, OCS, MTC (PHYSICAL THERAPIST/OWNER)
- **Authorized official phone:** (314) 991-2562

## Contact information

- **Practice address:** 763 S NEW BALLAS RD, 200, SAINT LOUIS, MO 63141-8704
- **Practice address phone:** (314) 991-2562
- **Mailing address:** 763 S NEW BALLAS RD, 200, SAINT LOUIS, MO 63141-8704
- **Mailing address phone:** (314) 991-2562

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 01532 | MO | Yes |

## Other

- **Enumeration date:** 12/03/2008
- **Last updated:** 06/22/2009