Organization
SPECIALTY REHAB & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY L BLANKENSHIP MS, OTR/L, CLT (OWNER/OCCUPATIONAL THERAPIST)
(314) 313-1088
Entity
Organization
Contact information
Practice address
3309 CRYSTAL LAKE DR, FESTUS, FESTUS, MO 63028-4274
(314) 313-1088
Mailing address
3309 CRYSTAL LAKE DR, FESTUS, FESTUS, MO 63028-4274
(314) 313-1088
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
2000175372
MO
Other
Enumeration date
08/22/2016
Last updated
08/22/2016
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