MEDICARE: MAX POWERS

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	2018026911	MO

General Provider Information

NPI Number	:	1821620857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAX POWERS

Provider Business Mailing Address
First Line	:	5609 N POLK DR
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64151-4613
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6311 N COSBY AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64151-2344
Country	:	US
Telephone Number	:	816-743-4667
Fax Number	:

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

Provider Enumeration Date	:	02/07/2020
Last Update Date	:	02/07/2020

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Directions to “ MAX POWERS ” Practice Location

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