Provider Demographics
NPI:1548573611
Name:KORSCHOT, ANDREA LEIGH (DPT)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:LEIGH
Last Name:KORSCHOT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6405 METCALF AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3931
Mailing Address - Country:US
Mailing Address - Phone:913-831-2721
Mailing Address - Fax:913-236-4211
Practice Address - Street 1:6405 METCALF AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-3931
Practice Address - Country:US
Practice Address - Phone:913-831-2721
Practice Address - Fax:913-236-4211
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-04111225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist