Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 102858 | MO |
N | 2081P2900X | Pain Medicine | MD102858 | MO |
NPI | 1104845585 |
---|---|
Provider Name | Dr. Terrence Pratt |
First Address | Kansas City, MO 64131-4517 |
Second Address | Lees Summit, MO 64086-6011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 09/08/2019 |