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General NPI Number Information
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NPI Number | 1174458939
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Entity Type | Individual
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Provider Name | ADDISON OLIVIA WARD
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Gender | Female
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Dates
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Enumeration Date | 06/15/2026
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Last Update Date | 06/15/2026
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Provider Practice Location Address
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Address Line | 7300 NALL AVE
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-2453
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Country | US
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Telephone | 913-335-0428
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Fax | 913-273-2572
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Provider Business Mailing Address
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Address Line | 22306 W 58TH ST
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City | SHAWNEE
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State | KS
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Zip | 66226-7916
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Country | US
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Telephone | 913-335-0428
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Fax | 913-273-9572
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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 | 11-08184
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License Number State | KS
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