Healthcare Provider Details

I. General information

NPI: 1639440191
Provider Name (Legal Business Name): LANETTE S KAPELS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2012
Last Update Date: 01/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11506 W CHARTWELL CIR
WICHITA KS
67205-2045
US

IV. Provider business mailing address

11506 W CHARTWELL CIR
WICHITA KS
67205-2045
US

V. Phone/Fax

Practice location:
  • Phone: 316-773-2331
  • Fax:
Mailing address:
  • Phone: 316-773-2331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number17-01623
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: