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General NPI Number Information
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NPI Number | 1144404666
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Entity Type | Organization
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Legal Business Name | REHABILITATION SPECIALISTS OF WICHITA PA
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Dates
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Enumeration Date | 12/19/2007
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Last Update Date | 04/24/2008
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Provider Practice Location Address
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Address Line | 1151 N ROCK RD
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City | WICHITA
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State | KS
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Zip | 67206-1262
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Country | US
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Telephone | 316-634-3409
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Fax | 316-634-3644
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Provider Business Mailing Address
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Address Line | 1151 N ROCK RD
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City | WICHITA
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State | KS
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Zip | 67206-1262
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Country | US
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Telephone | 316-634-3409
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Fax | 316-634-3644
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEVIN P RIEG
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Credential | M.D.
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Telephone | 316-634-3409
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 04-23692
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License Number State | KS
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