Most Relevant Information
Provider Data
| NPI Number: | 1003454562 |
| Provider Name: | STEPHANIE HENNINGSEN |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 2013033760 |
Most Important Dates
| Enumeration Date: | 12/16/2019 |
| Last Updated: | 12/19/2019 |
Provider Practice Location
307 S WOODS RD
CHESTERFIELD
MO
63017
Practice Location Phone/Fax
| Phone: | 3145765545 |
| Fax: |
Provider Mailing Location
307 S WOODS MILL RD
CHESTERFIELD
MO
630173418
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |