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General NPI Number Information
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NPI Number | 1427902386
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Entity Type | Individual
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Provider Name | ANDREW THOMAS MARTIN
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Gender | Male
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Dates
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Enumeration Date | 02/25/2026
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Last Update Date | 02/25/2026
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Provider Practice Location Address
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Address Line | 701 NE LAKEWOOD BLVD
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City | LEES SUMMIT
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State | MO
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Zip | 64064-1353
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Country | US
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Telephone | 816-607-7180
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Fax |
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Provider Business Mailing Address
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Address Line | 2138 JAYHAWK RD
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City | FORT SCOTT
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State | KS
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Zip | 66701-4614
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Country | US
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Telephone | 620-820-0085
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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 | 11-08099
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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 | 2026008210
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License Number State | MO
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