Provider Demographics
NPI:1861686792
Name:HILL, ZACKARY T (DPT)
Entity Type:Individual
Prefix:
First Name:ZACKARY
Middle Name:T
Last Name:HILL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 SW MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2904
Mailing Address - Country:US
Mailing Address - Phone:816-607-7180
Mailing Address - Fax:816-607-7181
Practice Address - Street 1:1321 SW MARKET ST
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-2904
Practice Address - Country:US
Practice Address - Phone:816-607-7180
Practice Address - Fax:816-607-7181
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007022416225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2007022416OtherLICENSE
1538431333OtherGROUP NPI
MO1861686792OtherINDIVIDUAL NPI
MA4008OtherMEDICARE PTAN