Provider Demographics
NPI:1346395142
Name:BLUE VALLEY PHYSICAL THERAPY,PA
Entity Type:Organization
Organization Name:BLUE VALLEY PHYSICAL THERAPY,PA
Other - Org Name:BLUE VALLEY PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-897-1100
Mailing Address - Street 1:15100 METCALF AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-2808
Mailing Address - Country:US
Mailing Address - Phone:913-897-1100
Mailing Address - Fax:913-897-9696
Practice Address - Street 1:10396 SOUTH RIDGEVIEW
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061
Practice Address - Country:US
Practice Address - Phone:913-599-4600
Practice Address - Fax:913-599-4605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS17-6546Medicare ID - Type Unspecified