Provider Demographics
NPI:1902550270
Name:ADJUVANT PHYSICAL THERAPY LLC.
Entity Type:Organization
Organization Name:ADJUVANT PHYSICAL THERAPY LLC.
Other - Org Name:ADJUVANT PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHASE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:816-908-9651
Mailing Address - Street 1:2708 NE FIELD CREEK CT
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-1448
Mailing Address - Country:US
Mailing Address - Phone:816-807-4433
Mailing Address - Fax:
Practice Address - Street 1:20101 E JACKSON DR STE C
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-1956
Practice Address - Country:US
Practice Address - Phone:816-807-4433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty