Provider Demographics
NPI:1245904044
Name:EMPOWER PTP LENEXA
Entity type:Organization
Organization Name:EMPOWER PTP LENEXA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:TIMM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:913-224-2990
Mailing Address - Street 1:5200 W 94TH TER STE 112
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66207-2534
Mailing Address - Country:US
Mailing Address - Phone:913-224-2990
Mailing Address - Fax:913-224-2992
Practice Address - Street 1:9900 PFLUMM RD STE 66
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-1231
Practice Address - Country:US
Practice Address - Phone:913-224-2990
Practice Address - Fax:913-224-2992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty