Provider Demographics
| NPI: | 1821838301 |
|---|---|
| Name: | VAN HAUTE, SAMUEL FRANCO (PT, DPT) |
| Entity type: | Individual |
| Prefix: | DR |
| First Name: | SAMUEL |
| Middle Name: | FRANCO |
| Last Name: | VAN HAUTE |
| Suffix: | |
| Gender: | M |
| 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: | 22120 MIDLAND DR |
| Mailing Address - Street 2: | SUITE 1 |
| Mailing Address - City: | OVERLAND PARK |
| Mailing Address - State: | KS |
| Mailing Address - Zip Code: | 66213-2883 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 913-745-4064 |
| Mailing Address - Fax: | 913-745-4352 |
| Practice Address - Street 1: | 121 N DEAN AVE STE 102 |
| Practice Address - Street 2: | |
| Practice Address - City: | RAYMORE |
| Practice Address - State: | MO |
| Practice Address - Zip Code: | 64083-8398 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 816-441-5656 |
| Practice Address - Fax: | |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2024-05-30 |
| Last Update Date: | 2024-10-04 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | |
| No | 2251E1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Ergonomics |
| No | 2251E1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Electrophysiology, Clinical |
| No | 2251G0304X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Geriatrics |
| No | 2251H1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Human Factors |
| No | 2251N0400X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology |
| No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics |
| No | 2251S0007X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports |
| No | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
