Provider Demographics
NPI:1720132608
Name:PREFERRED PT, LLC
Entity Type:Organization
Organization Name:PREFERRED PT, LLC
Other - Org Name:PREFERRED PT LANSING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:316-263-0003
Mailing Address - Street 1:PO BOX 803914
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-3914
Mailing Address - Country:US
Mailing Address - Phone:316-263-0003
Mailing Address - Fax:316-263-1241
Practice Address - Street 1:712 1ST TER
Practice Address - Street 2:STE 101
Practice Address - City:LANSING
Practice Address - State:KS
Practice Address - Zip Code:66043-1735
Practice Address - Country:US
Practice Address - Phone:913-727-2022
Practice Address - Fax:913-727-2033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS115692Medicare PIN