Healthcare Provider Details

I. General information

NPI: 1346395142
Provider Name (Legal Business Name): BLUE VALLEY PHYSICAL THERAPY,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10396 SOUTH RIDGEVIEW
OLATHE KS
66061
US

IV. Provider business mailing address

15100 METCALF AVE SUITE 102
OVERLAND PARK KS
66223-2808
US

V. Phone/Fax

Practice location:
  • Phone: 913-599-4600
  • Fax: 913-599-4605
Mailing address:
  • Phone: 913-897-1100
  • Fax: 913-897-9696

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: ANN TODD
Title or Position: PRESIDENT
Credential:
Phone: 913-897-1100