Healthcare Provider Details

I. General information

NPI: 1114469996
Provider Name (Legal Business Name): MICHAEL CHAFIC LARREA MOTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2016
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 W 1ST ST
SAINT FRANCIS KS
67756-3540
US

IV. Provider business mailing address

210 W 1ST ST
SAINT FRANCIS KS
67756-3540
US

V. Phone/Fax

Practice location:
  • Phone: 785-332-9600
  • Fax:
Mailing address:
  • Phone: 785-332-9600
  • Fax: 785-425-4297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number17-03889
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: