Individual
DYLAN ANTHONY PADBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1103880
KS
225100000X
Physical Therapist
Primary
2008032777
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730336314
BCBS KS
KS
01
—
41645082
BCBS KC
—
01
—
KA2868007
MEDICARE PTAN
KS
01
—
MA4370046
MEDICARE PTAN
MO
Enumeration date
08/26/2008
Last updated
05/08/2018
Update your record
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