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General NPI Number Information
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NPI Number | 1235766023
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Entity Type | Organization
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Legal Business Name | ACTION PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/24/2020
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 200 MAIN ST
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City | HALSTEAD
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State | KS
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Zip | 67056-1913
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Country | US
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Telephone | 316-835-7013
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Fax |
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Provider Business Mailing Address
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Address Line | 200 MAIN ST
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City | HALSTEAD
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State | KS
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Zip | 67056-1913
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Country | US
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Telephone | 316-835-7013
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RYAN COOK
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Credential | PT
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Telephone | 316-835-7013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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