Provider Demographics
NPI:1770964330
Name:PERRY, EMILY DANIELLE (DPT, PT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:DANIELLE
Last Name:PERRY
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:DANIELLE
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:PO BOX 219297
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64121-9297
Mailing Address - Country:US
Mailing Address - Phone:816-241-2131
Mailing Address - Fax:816-241-0551
Practice Address - Street 1:1931 BURLINGTON ST
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3407
Practice Address - Country:US
Practice Address - Phone:816-241-2131
Practice Address - Fax:816-241-0551
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-07769225100000X
MO2015016463225200000X
MO2024045331225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2015016463OtherMO STATE PTA LICENSE