Provider Demographics
NPI:1861642035
Name:PAUL THOMAS PHYSICAL THERAPY,LLC
Entity Type:Organization
Organization Name:PAUL THOMAS PHYSICAL THERAPY,LLC
Other - Org Name:CHAMPION PERFORMANCE & PHYSICAL THERAPY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HILLYARD
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:913-291-2290
Mailing Address - Street 1:7510 STATE LINE RD STE A
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-3400
Mailing Address - Country:US
Mailing Address - Phone:913-291-2290
Mailing Address - Fax:913-291-2449
Practice Address - Street 1:7510 STATE LINE RD STE A
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-3400
Practice Address - Country:US
Practice Address - Phone:913-291-2290
Practice Address - Fax:913-291-2449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty