Provider Demographics
NPI:1720583693
Name:THE VITAL SIX L.C.
Entity Type:Organization
Organization Name:THE VITAL SIX L.C.
Other - Org Name:VITAL SIX PHYSICAL THERAPY AND PERFORMANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:GEARHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-303-0032
Mailing Address - Street 1:2540 W PENNWAY ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2413
Mailing Address - Country:US
Mailing Address - Phone:913-303-0032
Mailing Address - Fax:816-659-2209
Practice Address - Street 1:2540 W PENNWAY ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2413
Practice Address - Country:US
Practice Address - Phone:913-303-0032
Practice Address - Fax:816-659-2209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-24
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy