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NPI Code Detail

MEDICARE: AMY WASTLER

MEDICARE:   AMY  WASTLER
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 Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12005017284OTHERMOLICENSE#

General Provider Information

NPI Number : 1255400503
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY WASTLER
Provider Business Mailing Address
First Line : 6105 W 54TH ST
Second Line :
City : MISSION
State : KS
Zip : 66202-1630
Country : US
Telephone Number : 913-432-7376
Fax Number :
Provider Business Practice Location Address
First Line : 2700 CLAY EDWARDS DR STE 150
Second Line :
City : N KANSAS CITY
State : MO
Zip : 64116-3268
Country : US
Telephone Number : 816-421-7246
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 07/08/2007

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Directions to “ AMY WASTLER ” Practice Location

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