Healthcare Provider Details

I. General information

NPI: 1619326493
Provider Name (Legal Business Name): ADAM HUTCHISON DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2016
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22120 MIDLAND DR STE 1
SHAWNEE KS
66226-3554
US

IV. Provider business mailing address

22346 W 66TH ST
SHAWNEE KS
66226-3560
US

V. Phone/Fax

Practice location:
  • Phone: 913-745-4064
  • Fax:
Mailing address:
  • Phone: 913-745-4064
  • Fax: 913-745-4352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-05375
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: