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General NPI Number Information
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NPI Number | 1861610214
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Entity Type | Individual
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Provider Name | VICKI D GINES PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2800 CLAY EDWARDS DR
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City | NORTH KANSAS CITY
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State | MO
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Zip | 64116-3220
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Country | US
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Telephone | 816-691-1358
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Fax |
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Provider Business Mailing Address
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Address Line | 6908 N BROOKSIDE RD
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City | PLEASANT VALLEY
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State | MO
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Zip | 64068-9589
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Country | US
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Telephone | 816-415-4092
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Fax | 816-415-3671
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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 | 2003007584
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License Number State | MO
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