Healthcare Provider Details

I. General information

NPI: 1417030255
Provider Name (Legal Business Name): MEGAN R. HERREN MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8516 N OAK TRFY
KANSAS CITY MO
64155-2433
US

IV. Provider business mailing address

5799 BROADMOOR STREET SUITE 300
MISSION KY
66202
US

V. Phone/Fax

Practice location:
  • Phone: 816-436-4500
  • Fax: 816-436-4510
Mailing address:
  • Phone: 913-384-5600
  • Fax: 913-384-0719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2005012173
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: