| Midwest Dysphagia Diagnostics Pc | |
|
1375 Sw 100th Rd, Holden, MO 64040-8440 | |
| (816) 986-0361 | |
| (816) 817-0922 |
| Full Name | Midwest Dysphagia Diagnostics Pc |
|---|---|
| Type | Facility |
| Speciality | Speech-language Pathologist |
| Location | 1375 Sw 100th Rd, Holden, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497119887 | NPI | - | NPPES |
| KA4003 | Other | KS | MEDICARE PTAN |
| MA6285 | Other | MO | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 2012041520 (Missouri) | Primary |
| Provider Name | David D Jensen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720066624 PECOS PAC ID: 1759281660 Enrollment ID: I20130905000151 |
| Provider Name | James D Lawrenzi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174550313 PECOS PAC ID: 0941357669 Enrollment ID: I20150804005245 |
| Provider Name | Ashley M Beam |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1215391693 PECOS PAC ID: 7517252299 Enrollment ID: I20160819000202 |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Dysphagia Diagnostics Pc 1375 Sw 100th Rd, Holden, MO 64040-8440 Ph: (816) 986-0361 | Midwest Dysphagia Diagnostics Pc 1375 Sw 100th Rd, Holden, MO 64040-8440 Ph: (816) 986-0361 |
Shelly Maddox, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1612 S Main St, Holden, MO 64040 Phone: 816-258-2301 | |
The Dyslexia Den Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 594 Sw 1271st Rd, Holden, MO 64040 Phone: 402-416-4878 | |
Dana J Van Meter Patton, M.S. CCC-SLP/L Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 594 Sw 1271, Holden, MO 64040 Phone: 816-726-7475 | |
Veronica Immethun, MS, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1375 Sw 100th Rd, Holden, MO 64040 Phone: 816-986-0361 |