Provider Demographics
NPI:1255823670
Name:SALIOA, GISELLE
Entity type:Individual
Prefix:
First Name:GISELLE
Middle Name:
Last Name:SALIOA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11315 COLORADO AVE UNIT F255
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64137-2671
Mailing Address - Country:US
Mailing Address - Phone:660-951-5488
Mailing Address - Fax:
Practice Address - Street 1:MAPLE WOOD CARE CENTER
Practice Address - Street 2:724 NE 79TH TERRACE
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118
Practice Address - Country:US
Practice Address - Phone:816-436-8940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017033904225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist