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General NPI Number Information
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NPI Number | 1710318407
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Entity Type | Organization
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Legal Business Name | TRINITY REHABILITATION SERVICES
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Dates
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Enumeration Date | 12/05/2013
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Last Update Date | 12/05/2013
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Provider Practice Location Address
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Address Line | 534 E LOULA ST
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City | OLATHE
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State | KS
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Zip | 66061-5402
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Country | US
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Telephone | 913-634-6844
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Fax |
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Provider Business Mailing Address
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Address Line | 534 E LOULA ST
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City | OLATHE
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State | KS
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Zip | 66061-5402
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Country | US
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Telephone | 913-634-6844
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. T BRET JORDAN
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Credential | MS PT
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Telephone | 913-634-6844
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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 | 01543
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 11-01516
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License Number State | KS
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