Provider Demographics
NPI:1326183435
Name:PAUL CHANG, R.P.T., P.C.
Entity Type:Organization
Organization Name:PAUL CHANG, R.P.T., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPANY PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:816-224-0003
Mailing Address - Street 1:2133 NW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-7734
Mailing Address - Country:US
Mailing Address - Phone:816-224-0003
Mailing Address - Fax:816-224-2199
Practice Address - Street 1:2133 NW 13TH ST
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-7734
Practice Address - Country:US
Practice Address - Phone:816-224-0003
Practice Address - Fax:816-224-2199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01066225100000X
MO2004015146225100000X
MO117715225100000X
MO2000154573225100000X
MO2001017951225100000X
MO117653225200000X
MO2001032670225X00000X
MO2003009838225X00000X
MO003203225X00000X
MO2003014702235Z00000X
MO106654235Z00000X
MO2000163575235Z00000X
MO116652235Z00000X
MO1999137881235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty