Organization
BOOST PHYSICAL THERAPY AND SPORTS PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLINT HOOPER (CHIEF OPERATING OFFICER)
(940) 390-7222
Entity
Organization
Contact information
Practice address
1102 W 101ST TER APT F, KANSAS CITY, MO 64114-4289
(314) 974-7669
Mailing address
1102 W 101ST TER APT F, KANSAS CITY, MO 64114-4289
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
11-05331
KS
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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