Organization
BOUTIQUE PHYSIO, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNE MACZA (PHYSICAL THERAPIST/OWNER)
(314) 802-7337
Entity
Organization
Contact information
Practice address
909 PURDUE AVE, UNIVERSITY CITY, MO 63130-3012
(314) 802-7337
Mailing address
909 PURDUE AVE, UNIVERSITY CITY, MO 63130-3012
(314) 802-7337
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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