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General NPI Number Information
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NPI Number | 1285094102
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Entity Type | Organization
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Legal Business Name | PELVIC HEALTH SPECIALISTS, LLC
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Dates
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Enumeration Date | 03/04/2016
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Last Update Date | 04/26/2016
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Provider Practice Location Address
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Address Line | 1112 W 6TH ST STE 212
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City | LAWRENCE
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State | KS
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Zip | 66044-2215
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Country | US
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Telephone | 785-727-7900
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Fax | 785-727-7901
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Provider Business Mailing Address
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Address Line | 601 SW CORPORATE VW STE 200 ATTN: CREDENTIALING
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City | TOPEKA
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State | KS
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Zip | 66615-1245
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Country | US
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Telephone | 785-581-0670
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Fax | 785-380-4793
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Authorized Official
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Title or Position | OWNER
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Name | CATHY L DAHL
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Credential | DO
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Telephone | 785-727-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | 05-29352
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License Number State | KS
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