Organization
SPORTS ENHANCEMENT GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN DOUGLAS (DIRECTOR OWNER)
(636) 728-0889
Entity
Organization
Contact information
Practice address
217 CHESTERFIELD TOWNE CTR, CHESTERFIELD, MO 63005-1257
(636) 728-0889
(636) 728-1553
Mailing address
217 CHESTERFIELD TOWNE CTR, CHESTERFIELD, MO 63005-1257
(636) 728-0889
(636) 728-1553
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/22/2007
Last updated
04/04/2008
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