Provider Demographics
NPI:1366072688
Name:ORR, JEFFERY (DPT, PT)
Entity type:Individual
Prefix:
First Name:JEFFERY
Middle Name:
Last Name:ORR
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 219297
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64121-9297
Mailing Address - Country:US
Mailing Address - Phone:417-429-4693
Mailing Address - Fax:417-753-7765
Practice Address - Street 1:223 SOUTH JEFFERSON STREET
Practice Address - Street 2:
Practice Address - City:AVA
Practice Address - State:MO
Practice Address - Zip Code:65608
Practice Address - Country:US
Practice Address - Phone:417-429-4693
Practice Address - Fax:417-753-7765
Is Sole Proprietor?:No
Enumeration Date:2020-01-26
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1106344225100000X
MO2019045304225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist