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NPI Code Detail

MEDICARE: BLAIR TWADDLE DPT

MEDICARE: BLAIR TWADDLE DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1255040333
Entity Type Code : Individual
Provider Name (Legal Business Name) : BLAIR TWADDLE DPT
Provider Business Mailing Address
First Line : 714 CRABAPPLE LN
Second Line :
City : LIBERTY
State : MO
Zip : 64068-4345
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8033 HOLMES RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64131-2115
Country : US
Telephone Number : 816-363-6222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2022
Last Update Date : 11/17/2022

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