Organization
REHAB DYNAMICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER NICEWANNER P.T. (DIRECTOR)
(314) 442-6249
Entity
Organization
Contact information
Practice address
10435 CLAYTON RD, SUITE 10, SAINT LOUIS, MO 63131-2909
(314) 442-6249
(314) 787-5949
Mailing address
10435 CLAYTON RD, SUITE 10, SAINT LOUIS, MO 63131-2909
(314) 442-6249
(314) 787-5949
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
211293
ANTHEM
MO
01
—
297989
GHP
MO
01
—
5716981
FIRST HEALTH
MO
01
—
699969
UNITEDHEALTHCARE
MO
01
—
760676
HEALTHLINK
MO
Enumeration date
06/25/2006
Last updated
08/22/2020
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