Provider Demographics
NPI:1134751324
Name:SHROYER, HEATH (LMT)
Entity type:Individual
Prefix:
First Name:HEATH
Middle Name:
Last Name:SHROYER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 W 75TH ST STE E
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-3503
Mailing Address - Country:US
Mailing Address - Phone:913-362-4800
Mailing Address - Fax:
Practice Address - Street 1:2110 W 75TH ST STE E
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-3503
Practice Address - Country:US
Practice Address - Phone:913-362-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist