Individual
SUSAN POLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 S KIRKWOOD RD STE 140, SAINT LOUIS, MO 63122-7250
(314) 821-5300
Mailing address
1758 WOODS BEND LN, GLENCOE, MO 63038-1448
(314) 966-2055
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01515
LICENSE #
MO
Enumeration date
08/30/2006
Last updated
07/08/2007
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