Provider Demographics
NPI:1285953562
Name:VEMMER, KIM K (OTR)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:K
Last Name:VEMMER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 SE WILLIAMSBURG CIR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-3621
Mailing Address - Country:US
Mailing Address - Phone:816-830-4408
Mailing Address - Fax:
Practice Address - Street 1:7501 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-2103
Practice Address - Country:US
Practice Address - Phone:816-237-2091
Practice Address - Fax:816-237-2065
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001091225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist