Healthcare Provider Details

I. General information

NPI: 1437292422
Provider Name (Legal Business Name): REBEKAH JANELL OWINGS OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9727 E SHANNON WOODS CIR
WICHITA KS
67226-4102
US

IV. Provider business mailing address

720 EASTRIDGE ST. N.
VALLEY CENTER KS
67147
US

V. Phone/Fax

Practice location:
  • Phone: 316-681-0824
  • Fax: 316-219-1349
Mailing address:
  • Phone: 316-648-8231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number17-01901
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: