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Contact Information

GARY PARK, PTA
13830 S 71 HIGHWAY
GRANDVIEW, MO64030
 Phone: 816-761-8088
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapy Assistant

225200000X
Indicates primary specialty

NPI Profile & details for GARY PARK · (Male)

NPI Number 1538238423
Status Active
Credentials PTA (Physical Therapist Assistant)
Entity Individual
Enumeration date 11/07/2006
Last updated 07/23/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • MO Other 117830 LICENSE#
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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