Organization
EVERSON ORTHOPEDIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAWN K EVERSON MHS, PT, OCS, MTC (PHYSICAL THERAPIST/OWNER)
(314) 991-2562
Entity
Organization
Contact information
Practice address
763 S NEW BALLAS RD, #200, SAINT LOUIS, MO 63141-8704
(314) 991-2562
Mailing address
763 S NEW BALLAS RD, #200, SAINT LOUIS, MO 63141-8704
(314) 991-2562
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
00423
MO
225100000X
Physical Therapist
Primary
01532
MO
225200000X
Physical Therapy Assistant
2005035740
MO
Other
Enumeration date
10/19/2006
Last updated
06/12/2008
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