Organization
LEGACY PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE M KALISIAK P.T. (PRESIDENT)
(636) 225-3649
Entity
Organization
Contact information
Practice address
2961 DOUGHERTY FERRY RD, SUITE 105, SAINT LOUIS, MO 63122-3374
(636) 225-3649
(888) 494-7074
Mailing address
2961 DOUGHERTY FERRY RD, SUITE 105, SAINT LOUIS, MO 63122-3374
(636) 225-3649
(888) 494-7074
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
11/10/2008
Last updated
02/03/2009
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