National Provider Identifier Database

LIFETIME REDESIGN OT PLLC
Geriatric Medicine

A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.


Contact Information

LIFETIME REDESIGN OT, PLLC
12395 OLIVE BLVD STE 200
SAINT LOUIS, MO63141-5465
Phone: 646-319-9017
Fax:
Website:
Specialty Taxonomy Code
* Geriatric Medicine 207QG0300X
Professional 101YP2500X

* Indicates primary specialty

NPI Profile & details for LIFETIME REDESIGN OT, PLLC

NPI Number 1013666403
Legal business name
LBN
LIFETIME REDESIGN OT, PLLC
Authorized official JOSEPH MITCHELL - (AUTHORIZED OFFICIAL)
Entity Organization
Organization subpart No
Enumeration date 03/22/2022
Last updated 05/29/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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