Most Relevant Information
Provider Data
| NPI Number: | 1003473786 |
| Provider Name: | DANIELLE BUCHANAN IVIE DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 2019017284 |
Most Important Dates
| Enumeration Date: | 05/28/2019 |
| Last Updated: | 02/25/2021 |
Provider Practice Location
4444 FOREST PARK AVE
STE 1210
SAINT LOUIS
MO
631082212
Practice Location Phone/Fax
| Phone: | 3142861940 |
| Fax: | 3142861473 |
Provider Mailing Location
4444 FOREST PARK AVE
CB 8502
SAINT LOUIS
MO
631082212
Provider Mailing Phone/Fax
| Phone: | 3142861940 |
| Fax: | 3142861473 |