Individual
JESSICA ASHLEY CHACKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1 CHILDRENS PL, SAINT LOUIS, MO 63110-1002
(314) 454-6154
(314) 454-2380
Mailing address
1428 DOLMAN ST, SAINT LOUIS, MO 63104-3315
(314) 276-5149
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2011031121
MO
Other
Enumeration date
10/11/2012
Last updated
10/11/2012
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