Provider Demographics
NPI:1003254913
Name:CHILDREN'S PHYSICAL THERAPY ASSOCIATES
Entity Type:Organization
Organization Name:CHILDREN'S PHYSICAL THERAPY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:FRYBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-345-1997
Mailing Address - Street 1:6600 COLLEGE BLVD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1939
Mailing Address - Country:US
Mailing Address - Phone:913-345-1997
Mailing Address - Fax:913-345-1990
Practice Address - Street 1:6600 COLLEGE BLVD
Practice Address - Street 2:SUITE 307
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1939
Practice Address - Country:US
Practice Address - Phone:913-345-1997
Practice Address - Fax:913-345-1990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST03588261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy