Healthcare Provider Details

I. General information

NPI: 1033294632
Provider Name (Legal Business Name): PATRICIA GAIL LAOCHINDA PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 06/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3730 N RIDGE RD SUITE 500
WICHITA KS
67205-1227
US

IV. Provider business mailing address

200 W DOUGLAS AVE STE 1040
WICHITA KS
67202-3013
US

V. Phone/Fax

Practice location:
  • Phone: 316-440-4901
  • Fax: 316-440-4904
Mailing address:
  • Phone: 316-263-0003
  • Fax: 316-263-1241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number1765
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1104385
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: