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Organization
PILATES PT LLC
Active
Organization
PILATES PT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STAN R GIDLEY CPC (BUSINESS MANAGER)
(816) 261-0654
Entity
Organization
Contact information
Practice address
2335 N BELT HWY, SUITE F, SAINT JOSEPH, MO 64506-5040
(816) 261-0654
(913) 273-1549
Mailing address
5201 BROOKHAVEN DR, SAINT JOSEPH, MO 64507-7767
(816) 261-0654
(913) 273-1549
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
11-03676
KS
261QP2000X
Physical Therapy Clinic/Center
Primary
2004030790
MO
Other
Enumeration date
02/26/2008
Last updated
03/22/2010
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