Healthcare Provider Details

I. General information

NPI: 1720069818
Provider Name (Legal Business Name): GERALD N LAMPE PT PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 03/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

373 W 101ST TER SUITE 200
KANSAS CITY MO
64114
US

IV. Provider business mailing address

20355 ANDERSON RD
WESTON MO
64098-9251
US

V. Phone/Fax

Practice location:
  • Phone: 816-246-1456
  • Fax: 816-286-2774
Mailing address:
  • Phone: 816-246-1456
  • Fax: 816-286-2774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number00147
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-00260
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: