Healthcare Provider Details

I. General information

NPI: 1740439355
Provider Name (Legal Business Name): KANSAS CITY HEALTH & WELLNESS CLINIC, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2008
Last Update Date: 04/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10074 WOODLAND RD
LENEXA KS
66220-3802
US

IV. Provider business mailing address

10074 WOODLAND RD
LENEXA KS
66220-3802
US

V. Phone/Fax

Practice location:
  • Phone: 913-393-2222
  • Fax: 913-393-2227
Mailing address:
  • Phone: 913-393-2222
  • Fax: 913-393-2227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081N0008X
TaxonomyNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
License Number05-29538
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-01788
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number01-05065
License Number StateKS
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number05-35619
License Number StateKS

VIII. Authorized Official

Name: DR. RYAN SCHELL
Title or Position: CO-OWNER
Credential: D.C.
Phone: 913-393-2222