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General NPI Number Information
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NPI Number | 1770213225
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Entity Type | Organization
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Legal Business Name | BOUNDLESS MOVEMENT LLC
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Dates
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Enumeration Date | 06/15/2022
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 13908 S BROOKWOOD CT
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City | OLATHE
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State | KS
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Zip | 66062-1928
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Country | US
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Telephone | 217-414-5321
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Fax |
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Provider Business Mailing Address
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Address Line | 13908 S BROOKWOOD CT
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City | OLATHE
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State | KS
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Zip | 66062-1928
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Country | US
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Telephone | 217-414-5321
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRET CROSSLAND
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Credential | DPT
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Telephone | 913-213-3632
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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 |
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License Number State |
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