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Organization

JOINT VENTURE REHABILITATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHAWN KELLY EVERSON PT, DPT, 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
261QP2000X
Physical Therapy Clinic/Center
Primary
01532
MO

Other

Enumeration date
12/03/2008
Last updated
06/22/2009
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