Healthcare Provider Details

I. General information

NPI: 1699102756
Provider Name (Legal Business Name): ACCESSIBILITY REMODELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2013
Last Update Date: 10/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6025 METCALF LN # 320
SHAWNEE MISSION KS
66202-2339
US

IV. Provider business mailing address

6025 METCALF LN # 320
SHAWNEE MISSION KS
66202-2339
US

V. Phone/Fax

Practice location:
  • Phone: 913-831-4444
  • Fax: 855-795-2669
Mailing address:
  • Phone: 913-831-4444
  • Fax: 855-795-2669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number3972668
License Number StateKS

VIII. Authorized Official

Name: MR. BRYON DEWILTON SUNDAY
Title or Position: CO-MEMBER
Credential:
Phone: 913-207-4538