| NPI | 1366611048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STAN R GIDLEY Business Manager 816-261-0654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MO 2004030790) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: KS 11-03676) |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2010-03-22 |