Provider Demographics
NPI:1326251422
Name:OLEKSY, MATTHEW JOSEPH (DPT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JOSEPH
Last Name:OLEKSY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15258 W 119TH ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-5604
Mailing Address - Country:US
Mailing Address - Phone:913-971-0422
Mailing Address - Fax:913-971-0425
Practice Address - Street 1:15258 W 119TH ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-5604
Practice Address - Country:US
Practice Address - Phone:913-971-0422
Practice Address - Fax:913-971-0425
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012041536225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
48800043OtherBCBS KC
MOMA4370062OtherMEDICARE PTAN