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Contact Information

LIFETIME REDESIGN OT, PLLC
12395 OLIVE BLVD STE 200
SAINT LOUIS, MO63141-5465
 Phone: 646-319-9017
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
 

Professional

101YP2500X
Indicates primary specialty

NPI Profile & details for LIFETIME REDESIGN OT, PLLC

NPI Number 1013666403
LBN Legal business name LIFETIME REDESIGN OT, PLLC
Authorized official JOSEPH MITCHELL - (AUTHORIZED OFFICIAL)
Entity Organization
Organization subpart 1 No
Enumeration date 03/22/2022
Last updated 05/29/2025 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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