Provider Demographics
NPI:1881028173
Name:O'CONNOR, JOSHUA JAMES
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:JAMES
Last Name:O'CONNOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6810 ANTIOCH RD
Mailing Address - Street 2:APT 157
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66204-1202
Mailing Address - Country:US
Mailing Address - Phone:913-912-9779
Mailing Address - Fax:
Practice Address - Street 1:6810 ANTIOCH RD
Practice Address - Street 2:APT 157
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-1202
Practice Address - Country:US
Practice Address - Phone:913-912-9779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant