Provider Demographics
NPI:1619108487
Name:MCGEEHEN, MARY COLLEEN
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:COLLEEN
Last Name:MCGEEHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 E RED BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-3606
Mailing Address - Country:US
Mailing Address - Phone:913-424-7847
Mailing Address - Fax:
Practice Address - Street 1:1108 E RED BRIDGE RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-3606
Practice Address - Country:US
Practice Address - Phone:913-424-7847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002029467225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant