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NPI Code Detail

MEDICARE: SUSANNE L. WORDEN PT

MEDICARE: SUSANNE L. WORDEN PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist11-00840KS

General Provider Information

NPI Number : 1083746739
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSANNE L. WORDEN PT
Provider Business Mailing Address
First Line : 2330 SHAWNEE MISSION PKWY
Second Line : MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312
City : WESTWOOD
State : KS
Zip : 66205-2005
Country : US
Telephone Number : 913-588-9000
Fax Number : 913-588-9822
Provider Business Practice Location Address
First Line : 4810 STATE AVE
Second Line : WYANDOTTE THERAPY
City : KANSAS CITY
State : KS
Zip : 66102-1748
Country : US
Telephone Number : 913-321-4567
Fax Number : 913-321-6789
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2007
Last Update Date : 09/24/2007

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