Provider Demographics
NPI:1578758603
Name:RHOADES, JOHN
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:RHOADES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7337 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-1357
Mailing Address - Country:US
Mailing Address - Phone:816-523-4600
Mailing Address - Fax:816-523-4724
Practice Address - Street 1:7337 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-1357
Practice Address - Country:US
Practice Address - Phone:816-523-4600
Practice Address - Fax:816-523-4724
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007022145225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist