Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 2004022969 | MO |
Y | 2251H1200X | Hand | 2004022969 | MO |
NPI | 1164481909 |
---|---|
Provider Name | Glenda Jane Alfier |
First Address | Saint Charles, MO 63301-2548 |
Second Address | Saint Peters, MO 63376-1666 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 13/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00322848 | RAILROAD MEDICARE (01) | MO |