Provider Demographics
NPI:1407008329
Name:THORNE, ANDREA (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:THORNE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4047 FERGUSON RD
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:KS
Mailing Address - Zip Code:66073-4175
Mailing Address - Country:US
Mailing Address - Phone:785-597-5640
Mailing Address - Fax:
Practice Address - Street 1:2401 GILLHAM RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-4619
Practice Address - Country:US
Practice Address - Phone:816-234-3380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002006963225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist