MEDICARE: CONNOR COTTON DPT 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
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1730945288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONNOR COTTON DPT PT

Provider Business Mailing Address
First Line	:	511 NE AGATE DR
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64064-1257
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 SW ARBORWALK BLVD STE B
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64082-4101
Country	:	US
Telephone Number	:	816-272-0664
Fax Number	:

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

Provider Enumeration Date	:	02/22/2024
Last Update Date	:	02/22/2024

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Directions to “ CONNOR COTTON DPT PT” Practice Location

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