Provider Demographics
NPI:1730846742
Name:MIND BODY SHEN
Entity type:Organization
Organization Name:MIND BODY SHEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:
Authorized Official - Last Name:KHEMRAJ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:503-560-4672
Mailing Address - Street 1:11501 W 81ST ST APT 220
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-3315
Mailing Address - Country:US
Mailing Address - Phone:503-560-4672
Mailing Address - Fax:
Practice Address - Street 1:8829 LONG ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-3586
Practice Address - Country:US
Practice Address - Phone:503-560-4672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty