Organization
CRESCENT PHYSICAL REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIKANDER M BAJWA PT (PRESIDENT)
(314) 616-1276
Entity
Organization
Contact information
Practice address
1519 VIRGINIA DR, ELLISVILLE, MO 63011-2046
(314) 616-1276
Mailing address
1519 VIRGINIA DR, ELLISVILLE, MO 63011-2046
(314) 616-1276
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
LC0531406
MO
Other
Enumeration date
04/21/2008
Last updated
04/21/2008
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