Individual
TAYLOR MARIE DETTMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, PT
Contact information
Practice address
2937 S BRENTWOOD BLVD, BRENTWOOD, MO 63144-2713
(314) 961-3804
(314) 961-1147
Mailing address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(630) 575-6200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2015023911
MO
225100000X
Physical Therapist
PTL.0013304
CO
Other
Enumeration date
07/14/2015
Last updated
12/01/2025
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