Individual
ABRAHAM PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
32 DILLON PLAZA DR, HIGH RIDGE, MO 63049-2478
(636) 677-3100
Mailing address
3371 WHITE OAK SCHOOL RD, EUREKA, MO 63025-2815
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2023016616
MO
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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