Organization
CHILDREN'S PHYSICAL THERAPY LLC
Active
Organization
CHILDREN'S PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA M PETERSEN PT, MS, PCS (OWNER)
(913) 345-9310
Entity
Organization
Contact information
Practice address
5250 W 94TH TER, SUITE 200, PRAIRIE VILLAGE, KS 66207-2502
(913) 345-1997
(913) 345-1990
Mailing address
5250 W 94TH TER, SUITE 200, PRAIRIE VILLAGE, KS 66207-2502
(913) 345-1997
(913) 345-1990
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1100490
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200355530A
—
KS
05
—
507615102
—
MO
Enumeration date
06/24/2006
Last updated
04/11/2014
Update your record
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