Organization
WINGHAVEN MANUAL PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL J WASHECK (OWNER, THERAPIST)
(636) 625-0408
Entity
Organization
Contact information
Practice address
9 WINGSPAN CT, LAKE SAINT LOUIS, MO 63367-1834
(636) 699-9357
Mailing address
21 MEADOWS CIRCLE DR STE 320, LAKE SAINT LOUIS, MO 63367-4110
(636) 625-0408
(636) 625-0411
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
LC001521081
MO
Other
Enumeration date
02/13/2017
Last updated
10/04/2023
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