Healthcare Provider Details

I. General information

NPI: 1881704500
Provider Name (Legal Business Name): JAYME L KRAL PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 02/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 6TH AVE #207
LEAVENWORTH KS
66048-3225
US

IV. Provider business mailing address

920 6TH AVE #207
LEAVENWORTH KS
66048-3225
US

V. Phone/Fax

Practice location:
  • Phone: 913-940-6423
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-03337
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2003022486
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: