MEDICARE: AUSTIN METTLING DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1106493	KS

General Provider Information

NPI Number	:	1225655475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUSTIN METTLING DPT

Provider Business Mailing Address
First Line	:	2081 N WEBB RD STE B
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67206-3403
Country	:	US
Telephone Number	:	316-260-8239
Fax Number	:	316-462-5767

Provider Business Practice Location Address
First Line	:	2081 N WEBB RD STE B
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67206-3403
Country	:	US
Telephone Number	:	316-260-8239
Fax Number	:	316-462-5767

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2020
Last Update Date	:	07/02/2020

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Directions to “ AUSTIN METTLING DPT” Practice Location

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