Provider Demographics
NPI:1225376221
Name:FREVERT, THOMAS EDWARD (DPT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:EDWARD
Last Name:FREVERT
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 1:501 NW VESPER ST
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-2745
Mailing Address - Country:US
Mailing Address - Phone:816-427-5300
Mailing Address - Fax:816-927-6342
Practice Address - Street 1:501 NW VESPER ST
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-2745
Practice Address - Country:US
Practice Address - Phone:816-427-5300
Practice Address - Fax:816-927-6342
Is Sole Proprietor?:No
Enumeration Date:2013-01-25
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-04599225100000X
MO2013000141225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist