Individual provider · Type 1 NPI

Elisha Anne Gillum, MPT

Pediatric Physical Therapist · St. Louis, MO

NPI number 1750413522 Active

Practice location

801 N 11th St, Medicaid Department
St. Louis, MO 63101-1015

Call (314) 345-2535 Map

Fax (314) 345-2653

Mailing address

1868 Cottonwood Dr
Imperial, MO 63052-1573

Specialties and licenses

TaxonomyCodeLicense
Pediatric Physical Therapist Primary 2251P0200X2001008315 (MO)

Pediatric Physical Therapist: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical th…

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About NPI 1750413522

Elisha Anne Gillum, MPT's National Provider Identifier is 1750413522, issued on Mar 9, 2007. The primary taxonomy on file is Pediatric Physical Therapist (2251P0200X), and the practice location is in St. Louis, MO. The record was last updated on Jul 8, 2007.