Healthcare Provider Details

I. General information

NPI: 1609449206
Provider Name (Legal Business Name): EMILY HIGGINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2021
Last Update Date: 05/06/2022
Certification Date: 05/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2258 N LAKEWAY CIR
WICHITA KS
67205-1082
US

IV. Provider business mailing address

3223 N OLIVER ST
WICHITA KS
67220-2106
US

V. Phone/Fax

Practice location:
  • Phone: 316-945-7117
  • Fax: 316-558-3400
Mailing address:
  • Phone: 316-558-3410
  • Fax: 316-267-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-04618
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: