Individual
ICHCHHA SHARMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7068 S OUTER 364, O FALLON, MO 63368-7757
(636) 240-6100
Mailing address
961 MOLLOY DR, O FALLON, MO 63366-3228
(405) 269-0452
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
12861
CT
225100000X
Physical Therapist
Primary
2021038886
MO
225100000X
Physical Therapist
PTL.0017545
CO
Other
Enumeration date
10/27/2023
Last updated
10/27/2023
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