Kelsey Dirksen

Individual provider Active NPI Physical Therapy Assistant · Kearney, MO

NPI 1083064786 · NPPES record last updated Jun 14, 2016

Key facts

NPI
1083064786
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2013045759 (MO)
Practice address
200 Meadowbrook Dr
Kearney, MO 64060-8553
Phone
(816) 744-8116
NPI assigned
Jun 14, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2013045759MOMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2013045759 MO Yes

Addresses

Primary practice location

200 Meadowbrook Dr
Kearney, MO 64060-8553

Mailing address

200 Meadowbrook Dr
Kearney, MO 64060-8553

Other providers in Kearney, MO

All providers in Kearney, MO · Physical Therapy Assistant in Missouri

Sources for this page

Verify at the official NPI Registry.