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General NPI Number Information
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NPI Number | 1366960684
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Entity Type | Individual
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Provider Name | JONATHON STARKE DPT
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Gender | Male
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Dates
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Enumeration Date | 09/07/2017
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 1855 S ROCK RD STE 155
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City | WICHITA
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State | KS
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Zip | 67207-5113
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Country | US
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Telephone | 316-682-6333
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Fax |
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Provider Business Mailing Address
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Address Line | 2023 N BROADMOOR ST UNIT 466
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City | WICHITA
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State | KS
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Zip | 67206-2699
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Country | US
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Telephone | 660-281-4420
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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 | 2017027012
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License Number State | MO
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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 | 11-07798
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License Number State | KS
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