Individual
MARY NIEMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 ALLEN AVE, SUITE 300, SAINT LOUIS, MO 63119-2344
(314) 961-3787
(314) 961-0974
Mailing address
5915 HIGHFIELD RD, SAINT LOUIS, MO 63109-3373
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00494
LICENSE #
MO
Enumeration date
08/29/2006
Last updated
07/08/2007
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