Organization
ELLISVILLE REHAB CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE ANNE SIESS D.C,. (OWNER)
(636) 256-0880
Entity
Organization
Contact information
Practice address
16075 MANCHESTER RD, ELLISVILLE, MO 63011-2103
(636) 256-0880
(636) 256-9153
Mailing address
16075 MANCHESTER RD, ELLISVILLE, MO 63011-2103
(636) 256-0880
(636) 256-9153
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
26-6639
MO
Other
Enumeration date
11/11/2010
Last updated
11/11/2010
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