Jessica Claire Antonacci, DPT
Individual provider Active NPI Physical Therapist · Saint Charles, MO
NPI 1558199455 · NPPES record last updated Jul 23, 2024
Key facts
- NPI
- 1558199455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2024029069 (MO)
- Practice address
- 711 Veterans Memorial Pkwy Ste 202
Saint Charles, MO 63303-2106 - Phone
- (636) 669-2345
- NPI assigned
- Jul 23, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024029069 | MO | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2024029069 | MO | Yes |
Addresses
Primary practice location
711 Veterans Memorial Pkwy Ste 202
Saint Charles, MO 63303-2106
Mailing address
711 Veterans Memorial Pkwy Ste 202
Saint Charles, MO 63303-2106
Other providers in Saint Charles, MO
- Angela'S Awesome Angels LLC
- Anger Management Associates
- Martha R Ankney
- Annies Hands Home Health Care LLC
- Anodyne Podiatry Services, LLC
- Marina Francesca Antonucci
- Aldrin Aquino
- Archway Associates of St. Louis, LLC
- Archway Lithotripsy, LLC
- Eboni R Armour
All providers in Saint Charles, MO · Physical Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.