Healthcare Provider Details

I. General information

NPI: 1588581045
Provider Name (Legal Business Name): CAMILLA SARVIS CPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10034 W 151ST ST
OVERLAND PARK KS
66221-9326
US

IV. Provider business mailing address

817 S RIDGEVIEW RD
OLATHE KS
66061-4924
US

V. Phone/Fax

Practice location:
  • Phone: 913-242-2195
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number14-01492
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: