OrganizationActive
Crescent Physical Rehabilitation, LLC
NPI 1154595122 · Rehabilitation Clinic/Center · Ellisville, MO
Provider details
- NPI number
- 1154595122
- Entity type
- Organization
- Primary specialty
- Rehabilitation Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Sikander Bajwa, President(314) 616-1276
- License
- LC0531406 (MO)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
1519 Virginia Dr
Ellisville, MO 63011-2046
Phone: (314) 616-1276
Approximate (ZIP-level) locationGet directions
Mailing address
1519 Virginia Dr
Ellisville, MO 63011-2046
Registry dates
- Enumerated
- 2008-04-21
- Last updated
- 2008-04-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.