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General NPI Number Information
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NPI Number | 1174121180
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Entity Type | Individual
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Provider Name | TOREY KERTZ
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Gender | Male
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Dates
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Enumeration Date | 10/12/2020
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | 9151 NE 81ST TER STE 110
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City | KANSAS CITY
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State | MO
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Zip | 64158-1176
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Country | US
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Telephone | 816-415-4971
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Fax |
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Provider Business Mailing Address
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Address Line | 16602 NE 121ST TER
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City | KEARNEY
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State | MO
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Zip | 64060-7454
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Country | US
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Telephone | 816-352-1298
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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 | 2020025035
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License Number State | MO
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