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General NPI Number Information
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NPI Number | 1295903250
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Entity Type | Organization
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Legal Business Name | FASTTRACK PHYSICAL THERAPY AND SPORTS REHABILITATION
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 01/12/2009
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Provider Practice Location Address
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Address Line | 2290 N TYLER RD #300
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City | WICHITA
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State | KS
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Zip | 67215
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Country | US
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Telephone | 316-722-5722
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Fax | 316-722-5734
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Provider Business Mailing Address
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Address Line | 2290 N TYLER RD #300
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City | WICHITA
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State | KS
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Zip | 67215
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Country | US
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Telephone | 316-722-5722
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Fax | 316-722-5734
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CATRINA M WARD
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Credential |
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Telephone | 316-722-5722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1102111
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License Number State | KS
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