Basic Information
| Provider Information | |||||||||
| NPI: | 1871218123 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOHLEN | ||||||||
| FirstName: | KASEY | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 219297 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641219297 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167920849 | ||||||||
| FaxNumber: | 8167921405 | ||||||||
| Practice Location | |||||||||
| Address1: | 527 N STATE ROUTE 291 STE A | ||||||||
| Address2: | |||||||||
| City: | LIBERTY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640681045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8167920849 | ||||||||
| FaxNumber: | 8167921405 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2022 | ||||||||
| LastUpdateDate: | 10/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 2022039505 | MO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.