Organization
GENESIS REHAB.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYRA R PHAN PHYSICAL THERAPY (PHYSICAT THERAPIST)
(314) 469-5008
Entity
Organization
Contact information
Practice address
12858 STRATHEARN DRIVE, ST. LOUIS, MO 63146
(314) 469-5008
Mailing address
12858 STRATHEARN DR, SAINT LOUIS, MO 63146-3773
(314) 469-5008
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100097
MO
Other
Enumeration date
09/01/2009
Last updated
09/01/2009
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