Basic Information
| Provider Information | |||||||||
| NPI: | 1356503437 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FREUND | ||||||||
| FirstName: | BRIAN | ||||||||
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| Credential: | MSPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4273 KEATON CROSSING BLVD | ||||||||
| Address2: | |||||||||
| City: | O FALLON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 633688220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3148219126 | ||||||||
| FaxNumber: | 3148219142 | ||||||||
| Practice Location | |||||||||
| Address1: | 221 SPENCER RD | ||||||||
| Address2: | SUITE D | ||||||||
| City: | SAINT PETERS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 633762438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6364779911 | ||||||||
| FaxNumber: | 6364779929 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2008 | ||||||||
| LastUpdateDate: | 06/20/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 118712 | MO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.