Individual
MICAH JB HUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, MPT
Contact information
Practice address
20120 E JACKSON DR STE B, INDEPENDENCE, MO 64057-2153
(816) 829-4050
(816) 829-4049
Mailing address
20120 E JACKSON DR STE B, INDEPENDENCE, MO 64057-2153
(816) 829-4050
(816) 829-4049
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2006022620
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37202071
BCBS KC
—
01
—
MA4370019
MEDICARE PTAN
MO
Enumeration date
06/14/2006
Last updated
01/10/2023
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