Individual
ANDREA N DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
1004 PROGRESS DR, SUITE 100, LANSING, KS 66043-6326
(913) 351-3838
(913) 351-3939
Mailing address
17134 BEL RAY PL, BELTON, MO 64012-5331
(816) 226-4011
(816) 524-6115
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-04531
KS
225100000X
Physical Therapist
2010017119
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689765588
BCBS KS
KS
01
—
45792042
BCBS KC
—
01
—
KA2868024
MEDICARE PTAN
KS
01
—
MA4370056
MEDICARE PTAN
MO
Enumeration date
09/27/2006
Last updated
01/20/2014
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