Healthcare Provider Details

I. General information

NPI: 1053123422
Provider Name (Legal Business Name): CRIST & PIESCHL REHABILITATION, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 C ST
WASHINGTON KS
66968-1909
US

IV. Provider business mailing address

535B RIDGE RD
WATERVILLE KS
66548-9140
US

V. Phone/Fax

Practice location:
  • Phone: 785-510-6018
  • Fax: 855-350-9509
Mailing address:
  • Phone: 785-562-7148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEBRA R BAKER
Title or Position: VP/ PT
Credential: DPT
Phone: 785-562-7148