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General NPI Number Information
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NPI Number | 1366538191
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Entity Type | Organization
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Legal Business Name | ADVANCED PT MCPHERSON LLC
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 03/05/2014
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Provider Practice Location Address
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Address Line | 400 W 4TH ST
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City | MCPHERSON
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State | KS
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Zip | 67460-2306
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Country | US
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Telephone | 620-241-4201
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Fax | 620-241-4210
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Provider Business Mailing Address
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Address Line | 200 W DOUGLAS STE 1040
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City | WICHITA
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State | KS
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Zip | 67200-3017
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Country | US
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Telephone | 316-263-0003
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Fax | 316-263-1241
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Authorized Official
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Title or Position | OWNER
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Name | DAVID C TODD
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Credential | P.T.
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Telephone | 316-260-6869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 11-01456
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License Number State | KS
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