Provider Demographics
NPI:1811000490
Name:TOWN, REXFORD L (PT)
Entity Type:Individual
Prefix:
First Name:REXFORD
Middle Name:L
Last Name:TOWN
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 1:5536 NE ANTIOCH RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-2301
Mailing Address - Country:US
Mailing Address - Phone:816-454-5818
Mailing Address - Fax:816-454-5994
Practice Address - Street 1:5536 NE ANTIOCH RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-2301
Practice Address - Country:US
Practice Address - Phone:816-454-5818
Practice Address - Fax:816-454-5994
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001006020225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
266642Medicare ID - Type Unspecified