Healthcare Provider Details

I. General information

NPI: 1740906452
Provider Name (Legal Business Name): HUNT4ABETTERU
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2022
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20120 E JACKSON DR STE B
INDEPENDENCE MO
64057-2153
US

IV. Provider business mailing address

1124 SE EASTRIDGE DR
BLUE SPRINGS MO
64014-3440
US

V. Phone/Fax

Practice location:
  • Phone: 816-877-3185
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICAH HUNT
Title or Position: OWNER
Credential: PT
Phone: 816-877-3185