Individual
MARYELLEN PETRIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1015 BOWLES AVE, FENTON, MO 63026-2394
(636) 496-2000
Mailing address
549 N VAN BUREN AVE, KIRKWOOD, MO 63122-3922
(314) 591-0456
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
08/02/2024
Last updated
08/02/2024
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