Provider Demographics
NPI:1588657621
Name:FERRANTELLE, FRANK JOSEPH (PT)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:JOSEPH
Last Name:FERRANTELLE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 SWIFT AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3426
Mailing Address - Country:US
Mailing Address - Phone:816-474-8877
Mailing Address - Fax:816-474-8878
Practice Address - Street 1:2100 SWIFT AVE
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3426
Practice Address - Country:US
Practice Address - Phone:816-474-8877
Practice Address - Fax:816-474-8878
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00815225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q792494Medicare ID - Type Unspecified