Individual
CASEY CANTWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20911 W 153RD ST, OLATHE, KS 66061-6219
(920) 342-0466
Mailing address
1040 W FAIRWOOD LN, OLATHE, KS 66061-2414
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
14-03400
KS
225200000X
Physical Therapy Assistant
14-03400
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14-03400
—
KS
Enumeration date
08/07/2019
Last updated
08/07/2019
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