Healthcare Provider Details

I. General information

NPI: 1043849250
Provider Name (Legal Business Name): D & T MANAGEMENT GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9747 E 21ST ST N STE 125
WICHITA KS
67206-3557
US

IV. Provider business mailing address

9747 E 21ST ST N STE 125
WICHITA KS
67206-3557
US

V. Phone/Fax

Practice location:
  • Phone: 316-634-1774
  • Fax:
Mailing address:
  • Phone: 316-634-1774
  • Fax: 316-217-9408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: TRACILYN BROWN
Title or Position: DELEGATED OFFICIAL
Credential:
Phone: 301-247-7291