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NPI Code Detail

MEDICARE: KENT MCCUISTION

MEDICARE:   KENT  MCCUISTION
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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1700295276
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENT MCCUISTION
Provider Business Mailing Address
First Line : 5104 NE 50TH ST
Second Line :
City : EL DORADO
State : KS
Zip : 67042-0729
Country : US
Telephone Number : 316-992-3833
Fax Number :
Provider Business Practice Location Address
First Line : 5104 NE 50TH ST
Second Line :
City : EL DORADO
State : KS
Zip : 67042-0729
Country : US
Telephone Number : 316-992-3833
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2014
Last Update Date : 08/08/2014

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Directions to “ KENT MCCUISTION ” Practice Location

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