Macy Sophanavong, DPT

NPI #1174357453 in Saint Peters, Missouri

Provider Information

NPI Number: 1174357453
Entity Type: Individual
Name: Macy Sophanavong, DPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: DPT
Enumeration Date: Aug 28, 2024
Last Updated: Aug 28, 2024

Practice Location

Address: 3639 N SAINT PETERS PKWY
City: Saint Peters
State: Missouri
ZIP Code: 63376-7303
Phone: (309) 256-2899

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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