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NPI Code Detail

MEDICARE: MISS MICHELLE MARGARET MCGAVRAN MSPT

MEDICARE: MISS MICHELLE MARGARET MCGAVRAN MSPT
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 Therapist2004014094MO
2225100000XPhysical Therapist11-03303KS

General Provider Information

NPI Number : 1356329718
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MICHELLE MARGARET MCGAVRAN MSPT
Provider Business Mailing Address
First Line : 9043 RENNER BLVD
Second Line : APT. 1908
City : LENEXA
State : KS
Zip : 66219-3004
Country : US
Telephone Number : 816-241-2131
Fax Number :
Provider Business Practice Location Address
First Line : 1931 BURLINGTON ST
Second Line :
City : NORTH KANSAS CITY
State : MO
Zip : 64116-3407
Country : US
Telephone Number : 816-241-2131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2006
Last Update Date : 07/08/2007

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Directions to “ MISS MICHELLE MARGARET MCGAVRAN MSPT” Practice Location

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