Organization
LEGACY HEALTHCARE SERVICES
Active
Other names
The Fountains of West County
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY ANN FIALA MOTR/L (OT/REHAB DIRECTOR)
(636) 448-2881
Entity
Organization
Contact information
Practice address
15822 CLAYTON RD, ELLISVILLE, MO 63011-2212
(636) 220-1681
(314) 200-4636
Mailing address
15822 CLAYTON RD, ELLISVILLE, MO 63011-2212
(636) 220-1681
(314) 200-4636
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2005028265
MO
Other
Enumeration date
01/08/2016
Last updated
01/08/2016
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