Amanda Rae Birdsong

Individual provider Active NPI Physical Therapist · Blue Springs, MO

NPI 1821774258 · NPPES record last updated Jun 22, 2023

Key facts

NPI
1821774258
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2023016599 (MO)
Practice address
111 NE Mock Ave
Blue Springs, MO 64014-2503
Phone
(816) 220-4200
NPI assigned
Jun 22, 2023
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
2023016599MOMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2023016599 MO Yes

Addresses

Primary practice location

111 NE Mock Ave
Blue Springs, MO 64014-2503

Mailing address

423 SW Joseph LN
Grain Valley, MO 64029-8411
Phone (816) 844-1496

Other providers in Blue Springs, MO

All providers in Blue Springs, MO · Physical Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.