Healthcare Provider Details

I. General information

NPI: 1831339126
Provider Name (Legal Business Name): ABIGAIL M KROLL D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2009
Last Update Date: 02/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 WORNALL RD
KANSAS CITY MO
64111-3220
US

IV. Provider business mailing address

7452 CHEROKEE DR
PRAIRIE VILLAGE KS
66208-3231
US

V. Phone/Fax

Practice location:
  • Phone: 816-932-2020
  • Fax:
Mailing address:
  • Phone: 913-766-6296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2008027620
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: