Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 2012012469 | MO |
N | 2251S0007X | Physical Therapist - Sports | 2012012469 | MO |
N | 2251X0800X | Physical Therapist - Orthopedic | 2012012469 | MO |
NPI | 1194067116 |
---|---|
Provider Name | Hassan R Jafri |
First Address | St. Louis, MO 63103 |
Second Address | St. Louis, MO 63103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2013 |
Last Update Date | 18/03/2013 |