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Individual

STACY MARIE BREWER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
11278 SCHUETZ RD, SAINT LOUIS, MO 63146-4957
(314) 991-4066
Mailing address
12655 MCKINSTRY RD, DE SOTO, MO 63020-3403
(636) 288-8718

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
2015022475
MO
225200000X
Physical Therapy Assistant
Primary
2015024275
MO

Other

Enumeration date
02/23/2021
Last updated
02/23/2021
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