Provider Demographics
NPI:1588841472
Name:MEYER, KRISTIE LEE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIE
Middle Name:LEE
Last Name:MEYER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MISS
Other - First Name:KRISTIE
Other - Middle Name:LEE
Other - Last Name:SPARROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:9820 KNOX DR
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-5226
Mailing Address - Country:US
Mailing Address - Phone:913-909-6552
Mailing Address - Fax:
Practice Address - Street 1:13157 STATE LINE RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64145-1650
Practice Address - Country:US
Practice Address - Phone:816-941-2550
Practice Address - Fax:816-941-2520
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005022047225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist