Organization
BRIGHT HORIZONS PEDIATRIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA FULLERTON (OWNER/OCCUPATIONAL THERAPIST)
(314) 541-7938
Entity
Organization
Contact information
Practice address
411 COUNTRY DOWNS DR, LAKE SAINT LOUIS, MO 63367-4310
(314) 541-7938
Mailing address
411 COUNTRY DOWNS DR, LAKE SAINT LOUIS, MO 63367-4310
(314) 541-7938
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2010025352
MO
Other
Enumeration date
03/25/2015
Last updated
07/17/2019
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