Doctor Name: | NICOLE GRAVINO |
NPI Number: | 1053788539 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | 11-05138 |
Business Practice Address: | 6264 Lewis Dr Ste 100 Parkville, MO - 641523603 |
Business Phone Number: | 8165878001 |
Business Fax Number: | |
Mailing Address: | 6264 Lewis Dr Ste 100, PARKVILLE |
State: | MO |
Postal Code: | 641523603 |
Phone Number: | 8165878001 |
Fax Number: | |
NPI Enumeration Date: | 08/31/2015 |
NPI Last Update Date: | 08/31/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 11-05138 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KS |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |