Provider Demographics
NPI:1912552779
Name:INJURY TREATMENT CENTERS OF KANSAS CITY, LLC
Entity Type:Organization
Organization Name:INJURY TREATMENT CENTERS OF KANSAS CITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WASSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAFER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-558-1918
Mailing Address - Street 1:1622 WESTPORT RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-4327
Mailing Address - Country:US
Mailing Address - Phone:816-886-9005
Mailing Address - Fax:
Practice Address - Street 1:1622 WESTPORT RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-4327
Practice Address - Country:US
Practice Address - Phone:816-886-9005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center