Organization
JUMPSTART PT 4 KIDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BECKER (PTA)
(636) 541-2398
Entity
Organization
Contact information
Practice address
643 KNOLLSHIRE WAY, DARDENNE PRAIRIE, MO 63368-8379
(636) 541-2398
(636) 265-2158
Mailing address
643 KNOLLSHIRE WAY, DARDENNE PRAIRIE, MO 63368-8379
(636) 541-2398
(636) 265-2158
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
109323
MO
225200000X
Physical Therapy Assistant
115066
MO
Other
Enumeration date
02/03/2014
Last updated
02/03/2014
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