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NPI Code Detail

MEDICARE: ERICA MCTAGGART CPTA CPTA

MEDICARE:   ERICA  MCTAGGART CPTA  CPTA
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
1225200000XPhysical Therapy Assistant14-03248KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
114-03248OTHERKSCPTA

General Provider Information

NPI Number : 1790286284
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA MCTAGGART CPTA CPTA
Provider Business Mailing Address
First Line : 6830 W 121ST COURT LEAWOOD
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66209
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 815 N ROTHSAY AVE
Second Line :
City : MINNEAPOLIS
State : KS
Zip : 67467-1637
Country : US
Telephone Number : 913-208-3641
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2018
Last Update Date : 06/16/2018

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