Provider Demographics
NPI:1477507275
Name:BENTSON, AMY E (RPT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:BENTSON
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 W 77TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2532
Mailing Address - Country:US
Mailing Address - Phone:913-341-1668
Mailing Address - Fax:
Practice Address - Street 1:10460 MASTIN ST
Practice Address - Street 2:SUITE 150
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-5701
Practice Address - Country:US
Practice Address - Phone:913-492-7870
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-00475225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist