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Organization
BOOST PHYSICAL THERAPY AND SPORTS PERFORMANCE
Active
Organization
BOOST PHYSICAL THERAPY AND SPORTS PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLINT HOOPER (CHIEF OPERATING OFFICER)
(940) 390-7222
Entity
Organization
Contact information
Practice address
1102 W 101ST TER APT F, KANSAS CITY, MO 64114-4289
(314) 974-7669
Mailing address
1102 W 101ST TER APT F, KANSAS CITY, MO 64114-4289
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
11-05331
KS
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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