Provider Demographics
NPI:1336874601
Name:1 ON 1 PT, LLC
Entity Type:Organization
Organization Name:1 ON 1 PT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:KLOS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:913-461-3982
Mailing Address - Street 1:12908 HOWE DRIVE
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209
Mailing Address - Country:US
Mailing Address - Phone:913-461-3982
Mailing Address - Fax:
Practice Address - Street 1:12908 HOWE DRIVE
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66209-1736
Practice Address - Country:US
Practice Address - Phone:913-461-3982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS7656036OtherBUSINESS ENTRY IDENTIFICATION