Provider Demographics
NPI:1326323726
Name:KANZLER, JEANNI G
Entity Type:Individual
Prefix:
First Name:JEANNI
Middle Name:G
Last Name:KANZLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 S LEXINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HARRISONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64701-2415
Mailing Address - Country:US
Mailing Address - Phone:816-380-2727
Mailing Address - Fax:816-380-3134
Practice Address - Street 1:503 S LEXINGTON ST
Practice Address - Street 2:
Practice Address - City:HARRISONVILLE
Practice Address - State:MO
Practice Address - Zip Code:64701-2415
Practice Address - Country:US
Practice Address - Phone:816-380-2727
Practice Address - Fax:816-380-3134
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004245225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist