Healthcare Provider Details

I. General information

NPI: 1194841643
Provider Name (Legal Business Name): ERIN MARIE DENNIHAN PT, MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 03/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 INTERNATIONAL PKWY SUITE 260
LAKE MARY FL
32746-5030
US

IV. Provider business mailing address

12334 GRANADA LN
LEAWOOD KS
66209-2635
US

V. Phone/Fax

Practice location:
  • Phone: 800-806-6026
  • Fax:
Mailing address:
  • Phone: 913-221-4310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2004021463
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-03412
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 4264
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: