Healthcare Provider Details

I. General information

NPI: 1619908647
Provider Name (Legal Business Name): PREFERRED PT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8550 MARSHALL DR STE 210
LENEXA KS
66214-9836
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 TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

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