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Individual

MR. EDWARD DELANEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, ATC/L

Contact information

Practice address
19550 E 39TH ST S, SUITE 425, INDEPENDENCE, MO 64057-2303
(816) 698-8846
Mailing address
5917 NE CORAL CIRCLE, LEES SUMMIT, MO 64064
(816) 729-4116

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2005028110
MO
2255A2300X
Athletic Trainer
2010017179
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2005028110
STATE LICENSE
MO
01
2010017179
STATE LICENSE - ATHLETIC TRAINING
MO
Enumeration date
06/23/2007
Last updated
12/06/2013
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