Organization
COLLEGE PARK ANCILLARY, LLC
Active
Other names
College Park Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES O CHAMBERS (ADMINISTRATOR)
(913) 469-0503
Entity
Organization
Contact information
Practice address
10600 MASTIN ST, OVERLAND PARK, KS 66212-5723
(913) 681-0606
(913) 338-1311
Mailing address
PO BOX 742554, ATLANTA, GA 30374-2105
(913) 469-0503
(913) 469-5267
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
03/29/2012
Last updated
10/11/2013
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