Provider Demographics
NPI:1437149663
Name:CASS COUNTY PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:CASS COUNTY PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:VAN METER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:816-322-4500
Mailing Address - Street 1:1290 W FOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-8300
Mailing Address - Country:US
Mailing Address - Phone:816-322-4500
Mailing Address - Fax:816-322-3135
Practice Address - Street 1:1290 W FOXWOOD DR
Practice Address - Street 2:
Practice Address - City:RAYMORE
Practice Address - State:MO
Practice Address - Zip Code:64083-8300
Practice Address - Country:US
Practice Address - Phone:816-322-4500
Practice Address - Fax:816-322-3135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO103243225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
25309010OtherBCBS
B980000Medicare ID - Type Unspecified