# BIONIC PHYSICAL THERAPY AND SPORTS PERFORMANCE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073949616
- **Authorized official:** ERIK HANSEN PT (PHYSICAL THERAPIST/OWNER)
- **Authorized official phone:** (913) 226-9240

## Contact information

- **Practice address:** 3800 S ELIZABETH ST, SUITE G, INDEPENDENCE, MO 64057-2650
- **Practice address phone:** (913) 226-9240
- **Mailing address:** 3800 S ELIZABETH ST, SUITE G, INDEPENDENCE, MO 64057-2650
- **Mailing address phone:** (913) 226-9240

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 1103527 | MO | Yes |

## Other

- **Enumeration date:** 09/15/2013
- **Last updated:** 09/15/2013