Individual
MICHAEL GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2415 N KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63113-1109
(314) 361-1300
(314) 367-4841
Mailing address
2415 N KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63113-1109
(314) 361-1300
(314) 367-4841
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2005005735
MO
Other
Enumeration date
02/09/2010
Last updated
02/09/2010
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