Provider Demographics
NPI:1992375273
Name:LENTELL, ANDREW JOHN (PT, DPT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOHN
Last Name:LENTELL
Suffix:
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12122 W 97TH ST APT 105
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-1628
Mailing Address - Country:US
Mailing Address - Phone:913-638-8869
Mailing Address - Fax:
Practice Address - Street 1:12932 W 87TH ST PKWY
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215
Practice Address - Country:US
Practice Address - Phone:913-638-8869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-06730225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist