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General NPI Number Information
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NPI Number | 1750479390
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Entity Type | Organization
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Legal Business Name | SALINA SPORTS MEDICINE & ORTHOPEDIC CLINIC
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 523 S SANTA FE AVE
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City | SALINA
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State | KS
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Zip | 67401
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Country | US
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Telephone | 785-823-7213
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Fax | 785-823-6887
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Provider Business Mailing Address
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Address Line | 523 S SANTA FE AVE
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City | SALINA
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State | KS
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Zip | 67401
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Country | US
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Telephone | 785-823-7213
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Fax | 785-823-6887
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MARCIA DIANA WOODS
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Credential |
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Telephone | 785-823-7213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 0417244
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License Number State | KS
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