Provider Demographics
NPI:1932141702
Name:K.B. THERAPY, INC.
Entity Type:Organization
Organization Name:K.B. THERAPY, INC.
Other - Org Name:PRIORITY PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BUNTEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:573-769-6166
Mailing Address - Street 1:1219 S MAIN ST
Mailing Address - Street 2:P.O. BOX 208
Mailing Address - City:PALMYRA
Mailing Address - State:MO
Mailing Address - Zip Code:63461-1943
Mailing Address - Country:US
Mailing Address - Phone:573-769-6166
Mailing Address - Fax:573-769-2356
Practice Address - Street 1:1219 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:MO
Practice Address - Zip Code:63461-1943
Practice Address - Country:US
Practice Address - Phone:573-769-6166
Practice Address - Fax:573-769-2356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1127225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty