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General NPI Number Information
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NPI Number | 1164729117
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Entity Type | Individual
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Provider Name | JESUS MANAPSAL JR. PT
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Gender | Male
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Dates
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Enumeration Date | 02/26/2011
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Last Update Date | 02/26/2011
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Provider Practice Location Address
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Address Line | 7101 E 21ST ST N
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City | WICHITA
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State | KS
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Zip | 67206-1044
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Country | US
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Telephone | 316-684-8018
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Fax |
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Provider Business Mailing Address
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Address Line | 1945 N ROCK RD 1318
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City | WICHITA
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State | KS
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Zip | 67206-1249
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Country | US
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Telephone | 336-200-3805
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11-04027
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License Number State | KS
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