Healthcare Provider Details

I. General information

NPI: 1811138357
Provider Name (Legal Business Name): ANGELA GRIFFITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2009
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8550 MARSHALL DR STE 210
LENEXA KS
66214-1505
US

IV. Provider business mailing address

PO BOX 803914
KANSAS CITY MO
64180-3914
US

V. Phone/Fax

Practice location:
  • Phone: 913-492-0333
  • Fax: 913-492-0334
Mailing address:
  • Phone: 316-263-0003
  • Fax: 316-263-1241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number14-02033
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: