Provider Demographics
NPI:1073755146
Name:COFFEY, JANIE MIRANDA (PT, MPT)
Entity Type:Individual
Prefix:
First Name:JANIE
Middle Name:MIRANDA
Last Name:COFFEY
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:JANIE
Other - Middle Name:MIRANDA
Other - Last Name:MEZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:500 E 112TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-3623
Practice Address - Country:US
Practice Address - Phone:816-942-3337
Practice Address - Fax:816-942-3350
Is Sole Proprietor?:No
Enumeration Date:2009-04-03
Last Update Date:2020-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT4144225100000X
MO2020037712225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist