Individual
MR. CHRISTOPHER ANDRE BEAVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
4335 W PINE BLVD, SAINT LOUIS, MO 63108-2205
(314) 371-0200
Mailing address
4626 WHISPER LAKE DR, FLORISSANT, MO 63033-4307
(314) 680-9510
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2010021288
MO
Other
Enumeration date
06/05/2012
Last updated
06/05/2012
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