Individual
MATTHEW D MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1825 E NORTH AVE, BELTON, MO 64012-2128
(816) 775-4747
(833) 964-0159
Mailing address
PO BOX 219297, KANSAS CITY, MO 64121-9297
(816) 775-4747
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1106463
KS
225100000X
Physical Therapist
Primary
2023020721
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1106463
LICENSE
KS
Enumeration date
07/07/2020
Last updated
12/08/2023
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