Provider Demographics
NPI:1154680148
Name:GREENWOOD, BRETT
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:GREENWOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 SHAWNEE MISSION PKWY APT 103
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202-4402
Mailing Address - Country:US
Mailing Address - Phone:620-704-0063
Mailing Address - Fax:
Practice Address - Street 1:7600 SHAWNEE MISSION PKWY APT 103
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-4402
Practice Address - Country:US
Practice Address - Phone:620-704-0063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant