Healthcare Provider Details

I. General information

NPI: 1720132608
Provider Name (Legal Business Name): PREFERRED PT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 1ST TER STE 101
LANSING KS
66043-1735
US

IV. Provider business mailing address

PO BOX 803914
KANSAS CITY MO
64180-3914
US

V. Phone/Fax

Practice location:
  • Phone: 913-727-2022
  • Fax: 913-727-2033
Mailing address:
  • Phone: 316-263-0003
  • Fax: 316-263-1241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DAVID C. TODD
Title or Position: OWNER
Credential: PT
Phone: 316-263-0003