Organization
PLAYABILITIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY REARDON (OFFICE MNGR/OCCUPATIONAL THERAPIST)
(913) 515-3531
Entity
Organization
Contact information
Practice address
3715 W 133RD ST, LEAWOOD, KS 66209-3347
(913) 515-3531
(816) 222-0679
Mailing address
3715 W 133RD ST, LEAWOOD, KS 66209-3347
(913) 213-3531
(816) 222-0679
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
11-03207
KS
Other
Enumeration date
04/21/2015
Last updated
12/10/2020
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