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General NPI Number Information
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NPI Number | 1922381102
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Entity Type | Individual
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Provider Name | KRISTEN MICHELLE MATTHEWS DPT
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Gender | Female
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 09/23/2011
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Provider Practice Location Address
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Address Line | 6700 ANTIOCH SUITE 120
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City | MERRIAM
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State | KS
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Zip | 66204
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Country | US
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Telephone | 913-652-9198
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Fax |
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Provider Business Mailing Address
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Address Line | 127 W 10TH ST #410
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City | KANSAS CITY
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State | MO
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Zip | 64105-1761
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Country | US
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Telephone | 785-341-5630
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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 | 2010039345
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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 | 11-04231
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License Number State | KS
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