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General NPI Number Information
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NPI Number | 1366756207
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Entity Type | Organization
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Legal Business Name | CORNERSTONE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 08/03/2010
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 11970 S BLACKBOB RD SUITE 100
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City | OLATHE
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State | KS
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Zip | 66062-2022
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Country | US
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Telephone | 913-393-0992
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Fax | 913-393-0169
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Provider Business Mailing Address
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Address Line | 11970 S BLACKBOB RD SUITE 100
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City | OLATHE
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State | KS
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Zip | 66062-2022
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Country | US
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Telephone | 913-393-0992
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Fax | 913-393-0169
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Authorized Official
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Title or Position | OWNER/MANAGING PARTNER
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Name | MS. NICOLE DIANE WINDSOR
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Credential | MPT, DPT, FAAOMPT
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Telephone | 913-393-0992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1103466
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License Number State | KS
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