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Organization

PURA VIDA THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALLEN CHILD PT (OWNER)
(913) 788-8888
Entity
Organization

Contact information

Practice address
12480 W 62ND TER STE 100, SHAWNEE, KS 66216-1871
(913) 788-8888
Mailing address
12480 W 62ND TER STE 100, SHAWNEE, KS 66216-1871
(913) 788-8888

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3484
PHYSICAL THERAPY
KS
Enumeration date
03/16/2007
Last updated
11/08/2016
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