Individual
MOLLY BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
343 WINDING WOODS CTR, O FALLON, MO 63366
(636) 439-2004
(636) 439-2054
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(630) 575-1980
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
13101
AZ
225100000X
Physical Therapist
Primary
2018045090
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13101
LICENSE
AZ
Enumeration date
06/30/2017
Last updated
07/21/2022
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