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General NPI Number Information
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NPI Number | 1346031507
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Entity Type | Individual
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Provider Name | COLLIN BRECKENRIDGE DPT
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Gender | Male
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 16990 W 86 STREET STE 110
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City | LENEXA
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State | KS
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Zip | 66219
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Country | US
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Telephone | 913-530-3477
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Fax |
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Provider Business Mailing Address
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Address Line | 208 KING ST
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City | KING CITY
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State | MO
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Zip | 64463-9644
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Country | US
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Telephone | 660-483-0387
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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 |
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License Number State |
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