Organization
LIFETIME REDESIGN OT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH MITCHELL (AUTHORIZED OFFICIAL)
(270) 993-4789
Entity
Organization
Contact information
Practice address
12395 OLIVE BLVD STE 200, SAINT LOUIS, MO 63141-5465
(646) 319-9017
Mailing address
1449 S MICHIGAN AVE STE 13138, CHICAGO, IL 60605-2810
(646) 319-9017
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
03/22/2022
Last updated
05/29/2025
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