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NPI 1790379840 · Physical Therapy Clinic/Center · Brentwood, MO
Provider details
- NPI number
- 1790379840
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Danielle Ivie, Member/Owner(661) 860-1762
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
567 Hanley Industrial Ct
Brentwood, MO 63144-1901
Phone: (314) 252-0504
Street-level locationGet directions
Mailing address
567 Hanley Industrial Ct
Brentwood, MO 63144-1901
Registry dates
- Enumerated
- 2021-03-01
- Last updated
- 2021-03-01
- Certified
- 2021-03-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.