| NPI | 1710318407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | T BRET JORDAN Owner 913-634-6844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: KS 11-01516) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: MO 01543) |
| Enumeration Date | 2013-12-05 |
| Last Update Date | 2013-12-05 |