Organization
ORTHOPAEDIC & SPORTS PHYSICAL THERAPY, INC.
Active
Other names
Telegraph Road Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EARL BRADEN BRASFIELD M.S.P.T., O.C.S. (DIRECTOR, PRESIDENT, AND CEO)
(314) 894-9008
Entity
Organization
Contact information
Practice address
2716 TELEGRAPH RD, SUITE #107, SAINT LOUIS, MO 63125-4078
(314) 894-9008
(314) 894-1232
Mailing address
2716 TELEGRAPH RD, SUITE #107, SAINT LOUIS, MO 63125-4078
(314) 894-9008
(314) 894-1232
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT118376
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2249965
FIRST HEALTH PROVIDER
MO
01
—
29153
COVENTRY
MO
01
—
31288
BC - BS CLINIC NUMBER
MO
Enumeration date
02/14/2007
Last updated
08/22/2020
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