# EMPOWERME WELLNESS KANSAS CITY, LLC

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

## Provider details

- **NPI number:** 1174118103
- **Authorized official:** JOHN DAVID CHURCH (VICE PRESIDENT OF FINANCE)
- **Authorized official phone:** (618) 972-5228

## Contact information

- **Practice address:** 1021 W E ST, BELLEVILLE, IL 62220-1055
- **Practice address phone:** (844) 502-7996
- **Mailing address:** 1335 STRASSNER DR, BRENTWOOD, MO 63144-1872
- **Mailing address phone:** (844) 502-7996

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/02/2021
- **Last updated:** 09/06/2024