Healthcare Provider Details

I. General information

NPI: 1730592825
Provider Name (Legal Business Name): AUSTIN M ROEPE DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 06/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3215 MAIN ST STE 202
KANSAS CITY MO
64111-1946
US

IV. Provider business mailing address

3215 MAIN ST STE 202
KANSAS CITY MO
64111-1946
US

V. Phone/Fax

Practice location:
  • Phone: 816-472-1800
  • Fax: 816-472-1880
Mailing address:
  • Phone: 816-472-1800
  • Fax: 816-472-1880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1104834
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: