Provider Demographics
NPI:1013962950
Name:KINSLOW, CHRISTOPHER D (PT, DC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:D
Last Name:KINSLOW
Suffix:
Gender:M
Credentials:PT, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 WALNUT STREET
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MO
Mailing Address - Zip Code:64098
Mailing Address - Country:US
Mailing Address - Phone:816-812-8262
Mailing Address - Fax:816-640-0135
Practice Address - Street 1:18215 STATE RT 45 N
Practice Address - Street 2:SUITE C
Practice Address - City:WESTON
Practice Address - State:MO
Practice Address - Zip Code:64098
Practice Address - Country:US
Practice Address - Phone:816-812-8262
Practice Address - Fax:816-386-9911
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005032878111N00000X
MO119374225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO10001822600OtherCHP
MO10001852100OtherCHP
MO693312OtherUNITED HEALTH CARE
MOT80D030OtherMEDICARE DC
MO693016OtherUNITED HEALTH CARE
MO32827028OtherBCBS
MOV08458Medicare UPIN
MO693312OtherUNITED HEALTH CARE
MO10001852100OtherCHP
MOT800000Medicare PIN