Healthcare Provider Details

I. General information

NPI: 1043581762
Provider Name (Legal Business Name): CHERIE F DARR P.T.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2012
Last Update Date: 01/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 WEST COLLEGE ST
LIBERTY MO
64068
US

IV. Provider business mailing address

9 TIMBER CREEK CIRCLE
PLATTE CITY MO
64079
US

V. Phone/Fax

Practice location:
  • Phone: 816-781-3020
  • Fax:
Mailing address:
  • Phone: 816-896-8886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2002025832
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: