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General NPI Number Information
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NPI Number | 1053264937
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Entity Type | Individual
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Provider Name | KATELYN JUSKIV
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Gender | Female
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Dates
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Enumeration Date | 02/19/2026
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 121 N DEAN AVE STE 102
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City | RAYMORE
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State | MO
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Zip | 64083-8398
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Country | US
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Telephone | 816-441-5656
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Fax |
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Provider Business Mailing Address
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Address Line | 113 S DEAN AVE APT 308
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City | RAYMORE
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State | MO
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Zip | 64083-8696
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2026005704
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License Number State | MO
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