Brett Lawrence Anderson

Individual provider Active NPI Physical Therapist · Troy, MO

NPI 1811540461 · NPPES record last updated Jul 23, 2019

Key facts

NPI
1811540461
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2019018674 (MO)
Practice address
148 Professional Pkwy
Troy, MO 63379-2823
Phone
(636) 356-1142
Fax
(636) 356-1442
NPI assigned
Jul 23, 2019
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Select Rehab St Louis LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2019018674 MO Yes

Addresses

Primary practice location

148 Professional Pkwy
Troy, MO 63379-2823

Mailing address

148 Professional Pkwy
Troy, MO 63379-2823
Phone (636) 356-1142

Other providers in Troy, MO

All providers in Troy, MO · Physical Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.