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General NPI Number Information
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NPI Number | 1669796371
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Entity Type | Organization
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Legal Business Name | WEST PLAINS PHYSICAL THERAPY INSTITUTE INC
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Dates
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Enumeration Date | 03/24/2010
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Last Update Date | 03/24/2010
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Provider Practice Location Address
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Address Line | 906 N KENTUCKY AVE
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City | WEST PLAINS
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State | MO
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Zip | 65775-2025
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Country | US
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Telephone | 417-255-2333
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Fax | 417-255-2332
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Provider Business Mailing Address
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Address Line | 906 N KENTUCKY AVE
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City | WEST PLAINS
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State | MO
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Zip | 65775-2025
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Country | US
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Telephone | 417-255-2333
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Fax | 417-255-2332
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Authorized Official
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Title or Position | OWNER
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Name | BRADLEY BENDER
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Credential | MPT
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Telephone | 417-255-2333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 2006030214
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License Number State | MO
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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 | 113699
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License Number State | MO
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