Provider Demographics
NPI:1851445894
Name:MAXIMUM FUNCTIONAL PERFORMANCE INC
Entity Type:Organization
Organization Name:MAXIMUM FUNCTIONAL PERFORMANCE INC
Other - Org Name:MAXIMUM PERFORMANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:E
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-776-0670
Mailing Address - Street 1:426 MCCALL RD # A
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-5032
Mailing Address - Country:US
Mailing Address - Phone:785-776-0670
Mailing Address - Fax:785-776-0096
Practice Address - Street 1:426 MCCALL RD # A
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-5032
Practice Address - Country:US
Practice Address - Phone:785-776-0670
Practice Address - Fax:785-776-0096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1102499225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS115592Medicare ID - Type Unspecified