Healthcare Provider Details

I. General information

NPI: 1710271150
Provider Name (Legal Business Name): SHANDRA NICOLE UKENS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHANDRA OYLER

II. Dates (important events)

Enumeration Date: 06/02/2011
Last Update Date: 02/06/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 N GREENWICH RD STE A
WICHITA KS
67206
US

IV. Provider business mailing address

1819 N GREENWICH RD STE A
WICHITA KS
67206
US

V. Phone/Fax

Practice location:
  • Phone: 316-260-8239
  • Fax: 316-462-5767
Mailing address:
  • Phone: 316-260-8239
  • Fax: 316-462-5767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4462
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: