Provider Demographics
NPI:1720338098
Name:BSP KANSAS
Entity type:Organization
Organization Name:BSP KANSAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:NEFF
Authorized Official - Suffix:
Authorized Official - Credentials:PT, ATC, CSCS
Authorized Official - Phone:816-377-5141
Mailing Address - Street 1:2105 KARA CT
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-1392
Mailing Address - Country:US
Mailing Address - Phone:816-407-1249
Mailing Address - Fax:816-407-1259
Practice Address - Street 1:16052 FOSTER STREET
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66085
Practice Address - Country:US
Practice Address - Phone:816-407-1249
Practice Address - Fax:816-407-1259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO11-04440261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy