MEDICARE: ABIGAIL FITZGERALD 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
1	225100000X	Physical Therapist	2008016023	MO

General Provider Information

NPI Number	:	1700041563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL FITZGERALD DPT

Provider Business Mailing Address
First Line	:	3215 MAIN ST STE 202
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-1946
Country	:	US
Telephone Number	:	816-472-1800
Fax Number	:

Provider Business Practice Location Address
First Line	:	3215 MAIN ST STE 202
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-1946
Country	:	US
Telephone Number	:	816-472-1800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2008
Last Update Date	:	06/03/2010

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