Provider Demographics
NPI: | 1063105062 |
---|---|
Name: | NEIGHBORHOOD NEUROPATHY MIDWEST LLC |
Entity type: | Organization |
Organization Name: | NEIGHBORHOOD NEUROPATHY MIDWEST LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | STEVEN |
Authorized Official - Middle Name: | ALAN |
Authorized Official - Last Name: | ZILKE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PT DC |
Authorized Official - Phone: | 314-408-8080 |
Mailing Address - Street 1: | 8460 WATSON RD STE 110 |
Mailing Address - Street 2: | |
Mailing Address - City: | SAINT LOUIS |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 63119-5273 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 314-408-8080 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 8460 WATSON RD STE 110 |
Practice Address - Street 2: | |
Practice Address - City: | SAINT LOUIS |
Practice Address - State: | MO |
Practice Address - Zip Code: | 63119-5273 |
Practice Address - Country: | US |
Practice Address - Phone: | 314-408-8080 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-05-26 |
Last Update Date: | 2023-05-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Single Specialty |