Provider Demographics
NPI:1194067116
Name:JAFRI, HASSAN R (PT, DPT)
Entity type:Individual
Prefix:
First Name:HASSAN
Middle Name:R
Last Name:JAFRI
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 OLIVE
Mailing Address - Street 2:#201 (INVIGORATE REHAB)
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63103
Mailing Address - Country:US
Mailing Address - Phone:314-467-8506
Mailing Address - Fax:
Practice Address - Street 1:1722 OLIVE
Practice Address - Street 2:SUTIE 201
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103
Practice Address - Country:US
Practice Address - Phone:314-467-8506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20120124692251G0304X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic