Provider Demographics
NPI:1891962452
Name:MUSSMAN, TIFFANY LYN (MPT)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:LYN
Last Name:MUSSMAN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10015 N AMBASSADOR DR STE 104
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64153-1437
Mailing Address - Country:US
Mailing Address - Phone:816-801-7878
Mailing Address - Fax:
Practice Address - Street 1:10015 N AMBASSADOR DR STE 104
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64153-1437
Practice Address - Country:US
Practice Address - Phone:816-801-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1103732251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics