Provider Demographics
NPI:1316326788
Name:ROLLINS, MARY E (PT)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:E
Last Name:ROLLINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:7508 BIG BEND BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-2104
Mailing Address - Country:US
Mailing Address - Phone:314-647-4880
Mailing Address - Fax:314-647-1964
Practice Address - Street 1:7508 BIG BEND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-2104
Practice Address - Country:US
Practice Address - Phone:314-647-4880
Practice Address - Fax:314-647-1964
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01121225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist