Provider Demographics
NPI:1104302843
Name:MCDONALD, MARIA (PT, DPT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13157 STATE LINE RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64145-1650
Mailing Address - Country:US
Mailing Address - Phone:816-941-2550
Mailing Address - Fax:816-941-2520
Practice Address - Street 1:13157 STATE LINE RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64145-1650
Practice Address - Country:US
Practice Address - Phone:816-941-2550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist