Potential Therapy Services LLC
Organization Active NPI Physical Therapy Clinic/Center · Ste Genevieve, MO
NPI 1104379353 · NPPES record last updated Aug 29, 2022
Key facts
- NPI
- 1104379353
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- License
- 2001001890 (MO)
- Legal business name
- POTENTIAL THERAPY SERVICES LLC
- Practice address
- 60 Plaza Dr
Ste Genevieve, MO 63670-1800 - Phone
- (573) 608-5058
- Fax
- (844) 912-8618
- NPI assigned
- Jul 24, 2016
- Organization subpart
- No
Authorized official
- Name
- Mr. Tyler R Brown, PT
- Title
- Owner
- Phone
- (573) 608-5058
Practitioners 27
-
Pamela Jane Bauer, OTR/L
-
Christopher M Cabral, PT, DPT
-
Haley M Graven, DPT
-
Maria S Rottler, PT
-
Andrew James Winch, P.T.
-
David Ross Buerck, P.T.
-
Emma Amalia Godat, DPT
-
Robin Leann Miller, DPT
-
Olivia Renee Vollmar, DPT
-
Bailey Parmley, DPT
-
Aaron Baker, DPT
-
Cherie M Haug, P.T., D.P.T.
-
Clinton Dale Rice, DPT
-
Randy A. Stepp, MACCC-SLP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170717003191 | MO | Part B Supplier - Clinic/Group Practice | 5890065361 |
Receives reassigned benefits from 17 practitioners Practice locations: Ste Genevieve, MO; Owensville, MO; Farmington, MO; Desloge, MO; Crystal City, MO; Bonne Terre, MO |
National Provider Directory
Locations
2308 N Truman Blvd
Crystal City, MO 63019
Phone (636) 206-6070
602 Maple Valley Dr
Farmington, MO 63640
Phone (573) 756-2999
233 Merchant St
Ste Genevieve, MO 63670
60 Plaza Dr
Ste Genevieve, MO 63670
Phone (573) 608-5058
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | 2001001890 | MO | Yes |
Addresses
Primary practice location
60 Plaza Dr
Ste Genevieve, MO 63670-1800
Mailing address
60 Plaza Dr
Ste Genevieve, MO 63670-1800
Phone (573) 608-5058
Other providers in Ste Genevieve, MO
- Richard Pietsek
- John Westley Pipkin
- Keeli Plati
- Plaza Chiropractic and Acupuncture, P.C.
- Kirsti Emalyn Pohlman
- Sandra Marie Przybylski
- Rainbow Kids Pediatrics
- Niranjana Raju
- Kim R Reef
- Ashley Regelsperger
All providers in Ste Genevieve, MO · Physical Therapy Clinic/Center in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.