Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | RO353 | MO |
NPI | 1003069980 |
---|---|
Provider Name | Ms. Martha J Rubinelli |
First Address | Webster Groves, MO 63119-4643 |
Second Address | Saint Louis, MO 63105-1817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2008 |
Last Update Date | 23/10/2008 |