Provider Demographics
NPI:1578717906
Name:DURAN, CHERYL M (PT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:M
Last Name:DURAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 SWIFT AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3423
Mailing Address - Country:US
Mailing Address - Phone:816-221-0058
Mailing Address - Fax:816-471-7966
Practice Address - Street 1:2025 SWIFT AVE
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3423
Practice Address - Country:US
Practice Address - Phone:816-221-0058
Practice Address - Fax:816-471-7966
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-03279225100000X
MO2005036997225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist