Healthcare Provider Details

I. General information

NPI: 1639844392
Provider Name (Legal Business Name): MVP PHYSICAL THERAPY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2021
Last Update Date: 05/12/2022
Certification Date: 05/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13628 W 87TH STREET PKWY
LENEXA KS
66215-4509
US

IV. Provider business mailing address

13628 W 87TH STREET PKWY
LENEXA KS
66215-4509
US

V. Phone/Fax

Practice location:
  • Phone: 913-638-8869
  • Fax: 844-777-4404
Mailing address:
  • Phone: 913-638-8869
  • Fax: 844-777-4404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW JOHN LENTELL
Title or Position: CEO
Credential: PT, DPT
Phone: 913-638-8869