Provider Demographics
NPI:1851808406
Name:KUEHNEL, TODD
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:KUEHNEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1887 N STATE HIGHWAY CC
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-8015
Mailing Address - Country:US
Mailing Address - Phone:417-234-1612
Mailing Address - Fax:417-725-5915
Practice Address - Street 1:1887 N STATE HIGHWAY CC
Practice Address - Street 2:
Practice Address - City:NIXA
Practice Address - State:MO
Practice Address - Zip Code:65714-8015
Practice Address - Country:US
Practice Address - Phone:417-234-1612
Practice Address - Fax:417-725-5915
Is Sole Proprietor?:No
Enumeration Date:2018-01-04
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO105704225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist