Organization
TRAUMA RECOVERY SERVICES, INC.
Active
Organization
TRAUMA RECOVERY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN L. NIETERS PH.D. (OWNER)
(913) 469-6069
Entity
Organization
Contact information
Practice address
10925 ANTIOCH RD STE 103, OVERLAND PARK, KS 66210-2119
(913) 469-6069
(913) 469-0604
Mailing address
10925 ANTIOCH RD STE 103, OVERLAND PARK, KS 66210-2119
(913) 469-6069
(913) 469-0604
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP-377
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100240310A
—
KS
Enumeration date
02/13/2012
Last updated
02/13/2012
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