Individual
BRIAN T. BOERNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
11504 W 135TH ST, OVERLAND PARK, KS 66221-2892
(913) 681-9909
(913) 681-9906
Mailing address
19631 W 97TH ST, LENEXA, KS 66220-3349
(913) 522-2875
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1103448
KS
225100000X
Physical Therapist
2004017077
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29971
FREEDOM NETWORK
KS
01
—
29971025
BCBS
KS
01
—
5712220
FIRST HEALTH
KS
01
—
7907868
AETNA
KS
Enumeration date
05/21/2007
Last updated
07/10/2014
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