Provider Demographics
NPI:1083669857
Name:MEINERS, KELLY M (PT)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:M
Last Name:MEINERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 COLLEGE BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1520
Mailing Address - Country:US
Mailing Address - Phone:913-451-7372
Mailing Address - Fax:913-451-7375
Practice Address - Street 1:6600 COLLEGE BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1520
Practice Address - Country:US
Practice Address - Phone:913-451-7372
Practice Address - Fax:913-451-7375
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-02985225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS29154094OtherBCBS
KS29154094OtherBCBS