| NPI | 1568855765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE L WALSH Owner 816-547-9654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: KS 1102863) |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2025-10-17 |