Individual
ADRIENNE EBERSOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
514 S MAIN ST, O FALLON, MO 63366-2535
(636) 730-1188
Mailing address
14515 N OUTER 40 RD STE 110, CHESTERFIELD, MO 63017-5746
(573) 220-0850
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2020016709
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2020016709
PHYSICAL THERAPIST
MO
Enumeration date
07/07/2020
Last updated
07/07/2020
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