Healthcare Provider Details

I. General information

NPI: 1891621405
Provider Name (Legal Business Name): HARRISON WERNER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 NW SOUTH OUTER RD # MO
BLUE SPRINGS MO
64015-1719
US

IV. Provider business mailing address

7275 NE 47TH ST
KANSAS CITY MO
64117-1459
US

V. Phone/Fax

Practice location:
  • Phone: 816-709-3319
  • Fax:
Mailing address:
  • Phone: 402-321-5731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2026028668
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: