Cvpt-Olivette, LLC

NPI #1124212816 in Fenton, Missouri

Provider Information

NPI Number: 1124212816
Entity Type: Organization
Organization Name: Cvpt-Olivette, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: CVPT-OLIVETTE, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Sep 5, 2007
Last Updated: Jan 9, 2008

Practice Location

Address: 2558 GLADIATOR DR
City: Fenton
State: Missouri
ZIP Code: 63026-2285
Phone: (636) 861-6969

Authorized Official

Name: MICHAEL GORMAN, PT, MOMT
Title: OWNER
Phone: (636) 728-1777

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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