Healthcare Provider Details

I. General information

NPI: 1306376892
Provider Name (Legal Business Name): EMILY MARIE O'LAUGHLIN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2017
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7405 RENNER RD
SHAWNEE KS
66217-9414
US

IV. Provider business mailing address

7911 NW WESTSIDE DR
WEATHERBY LAKE MO
64152-1543
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-3510
  • Fax: 913-588-3508
Mailing address:
  • Phone: 816-401-2521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-05689
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: