Organization
BACK TO LIFE WELLNESS CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARLENE D SCRUGGS (PRESIDENT)
(314) 280-9730
Entity
Organization
Contact information
Practice address
2331 HAMPTON AVE, SAINT LOUIS, MO 63139-2908
(314) 280-9730
Mailing address
54 FOUNTAINVEW DR, SAINT CHARLES, MO 63303-3049
(314) 280-9730
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
MO
Other
Enumeration date
04/19/2007
Last updated
08/22/2020
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