Individual
KEYANNA DEBOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
6264 LEWIS DR STE 100, PARKVILLE, MO 64152-3603
(816) 587-8001
Mailing address
960 ABBOTT ST, HENDERSON, NC 27536-3023
(913) 605-2572
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1107197
KS
225100000X
Physical Therapist
CP011884T
VA
225100000X
Physical Therapist
CP015406T
MD
225100000X
Physical Therapist
Primary
CP017326T
MO
225100000X
Physical Therapist
P21339
NC
Other
Enumeration date
09/22/2022
Last updated
03/24/2023
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