Organization
RE ACTIVE TRAINING & REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY LYNN BRAY DPT (ADMINISTRATOR)
(636) 443-9910
Entity
Organization
Contact information
Practice address
1401 GETTYSBURG LNDG, SAINT CHARLES, MO 63303-6104
(636) 443-9910
(636) 200-3601
Mailing address
1401 GETTYSBURG LNDG, SAINT CHARLES, MO 63303-6104
(636) 443-9910
(636) 200-3601
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
09/15/2021
Last updated
10/05/2021
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