Organization
PROFESSIONAL ATHLETIC REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL PATRICK BERRY LAT (DIRECTOR OF SPORTS MEDICINE)
(314) 598-1663
Entity
Organization
Contact information
Practice address
1 UNIVERSITY BLVD, 225 MARK TWAIN BUILDING, SAINT LOUIS, MO 63121-4400
(314) 598-1663
(314) 516-5503
Mailing address
1 UNIVERSITY BLVD, 225 MARK TWAIN BUILDING, SAINT LOUIS, MO 63121-4400
(314) 598-1663
(314) 516-5503
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/31/2011
Last updated
10/31/2011
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