Organization
LIVING ACTIVE REHAB & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY BRAY PT, DPT (OWNER, CEO)
(636) 443-9910
Entity
Organization
Contact information
Practice address
1401 GETTYSBURG LNDG, SAINT CHARLES, MO 63303-6104
(636) 443-9910
Mailing address
1401 GETTYSBURG LNDG, SAINT CHARLES, MO 63303-6104
(636) 443-9910
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
08/04/2020
Last updated
09/15/2020
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