Civello, Jesse Marie
Civello, Jesse Marie is an individual health care provider with primary practice located at 222 S Meramec Avenue Suite 100, Clayton MO 63105. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Civello, Jesse Marie can be contacted via phone (314) 707-4179.Contact Information
Primary practice address
222 S Meramec Avenue Suite 100
Clayton MO 63105
Phone: (314) 707-4179
Fax: (314) 286-1473
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 2013043933 | Missouri |
Profile Details
| NPI number | 1861814261 |
|---|---|
| LBN Legal business name | Civello, Jesse Marie |
| Credentials | DPT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 20th, 2014 |
| Last updated | Dec 11th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861814261 | NPPES |
| Missouri | MEDICAID | 480057326 |
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