Provider Demographics
NPI:1932387909
Name:DRAZEN, JEAN Z (PT)
Entity type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:Z
Last Name:DRAZEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1658 LEGEND LANE CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-4872
Mailing Address - Country:US
Mailing Address - Phone:314-997-6832
Mailing Address - Fax:
Practice Address - Street 1:3201 PARKWOOD LN
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-1334
Practice Address - Country:US
Practice Address - Phone:314-344-8978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00777225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist