Provider Demographics
NPI:1780449777
Name:SPENCER, AIMEE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 E FRANK ST
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:MO
Mailing Address - Zip Code:64060-8600
Mailing Address - Country:US
Mailing Address - Phone:816-301-0431
Mailing Address - Fax:
Practice Address - Street 1:100 E 6TH ST STE 3
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:MO
Practice Address - Zip Code:64060-8631
Practice Address - Country:US
Practice Address - Phone:816-200-1621
Practice Address - Fax:816-320-0022
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024006185225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist