Organization
MTS-DES PERES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JUSTIN GORMAN PT, MOMT, DMT (OWNER)
(636) 728-1777
Entity
Organization
Contact information
Practice address
12360 MANCHESTER RD, SUITE 150, DES PERES, MO 63131-4312
(636) 728-1777
(636) 728-1793
Mailing address
17300 N OUTER 40 RD, SUITE 205, CHESTERFIELD, MO 63005-1364
(636) 728-1777
(636) 728-1793
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LC1029655
MO
Other
Enumeration date
01/26/2010
Last updated
01/26/2010
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