| Doctor Name: | DR. NICOLE ANDERSON |
| NPI Number: | 1801236914 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.P.T. |
| License Number: | 11-04570 |
| Business Practice Address: | 5601 Ne Antioch Rd Ste 7 Gladstone, MO - 641192300 |
| Business Phone Number: | 8164524488 |
| Business Fax Number: | |
| Mailing Address: | 5601 Ne Antioch Rd, Ste 7 GLADSTONE |
| State: | MO |
| Postal Code: | 641192300 |
| Phone Number: | 8164524488 |
| Fax Number: | |
| NPI Enumeration Date: | 07/03/2013 |
| NPI Last Update Date: | 07/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 11-04570 |
| 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 |