Individual
VICKI GARVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
BANSHEE RD BLDG 4, BRIDGETON, MO 63044
(314) 234-6955
Mailing address
15315 OLD HALLS FERRY RD, FLORISSANT, MO 63034-1612
(314) 831-5199
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116948
LICENSE #
MO
Enumeration date
08/30/2006
Last updated
07/08/2007
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