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General NPI Number Information
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NPI Number | 1184768335
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Entity Type | Individual
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Provider Name | SCOTT PETERS MPT
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Gender | Male
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 01/08/2008
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Provider Practice Location Address
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Address Line | 1931 BURLINGTON ST
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City | N KANSAS CITY
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State | MO
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Zip | 64116-3407
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Country | US
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Telephone | 816-241-2131
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Fax | 816-241-0551
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Provider Business Mailing Address
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Address Line | 1931 BURLINGTON ST
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City | N KANSAS CITY
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State | MO
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Zip | 64116-3407
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Country | US
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Telephone | 816-241-2131
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Fax | 816-241-0551
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 11-03768
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | IL
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