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NPI Code Detail

MEDICARE: DAVIS CANTWELL DPT

MEDICARE: DAVIS CANTWELL DPT
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 Therapist11-06869KS

General Provider Information

NPI Number : 1245901594
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVIS CANTWELL DPT
Provider Business Mailing Address
First Line : 22120 MIDLAND DR STE 1
Second Line :
City : SHAWNEE
State : KS
Zip : 66226-3554
Country : US
Telephone Number : 913-745-4064
Fax Number : 913-745-4352
Provider Business Practice Location Address
First Line : 2113 E KANSAS CITY RD
Second Line :
City : OLATHE
State : KS
Zip : 66061-7050
Country : US
Telephone Number : 913-791-0144
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2021
Last Update Date : 12/22/2025

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