Provider Demographics
NPI:1801470950
Name:JUSTMANN, TAYLOR (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:JUSTMANN
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 W 85TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-2809
Mailing Address - Country:US
Mailing Address - Phone:913-982-6167
Mailing Address - Fax:
Practice Address - Street 1:3715 W 133RD ST
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66209-3347
Practice Address - Country:US
Practice Address - Phone:913-213-3531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist