Healthcare Provider Details

I. General information

NPI: 1730115031
Provider Name (Legal Business Name): HANDWORX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 07/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18540 METCALF AVE
STILWELL KS
66085-9450
US

IV. Provider business mailing address

18540 METCALF AVE
STILWELL KS
66085-9450
US

V. Phone/Fax

Practice location:
  • Phone: 913-209-9558
  • Fax: 913-402-1906
Mailing address:
  • Phone: 913-209-9558
  • Fax: 913-402-1906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number11-03103
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number11-03103
License Number StateKS

VIII. Authorized Official

Name: MARSHA B. LAWRENCE
Title or Position: OWNER
Credential: PT CHT
Phone: 913-209-9558