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General NPI Number Information
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NPI Number | 1760261424
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Entity Type | Individual
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Provider Name | MR. ALEX OLBERDING
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Gender | Male
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Dates
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Enumeration Date | 09/22/2023
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Last Update Date | 10/08/2023
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Provider Practice Location Address
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Address Line | 911 COMMERCIAL ST
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City | EMPORIA
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State | KS
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Zip | 66801-2916
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Country | US
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Telephone | 316-990-5158
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Fax |
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Provider Business Mailing Address
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Address Line | 1054 S CYPRESS ST
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City | WICHITA
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State | KS
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Zip | 67207-3613
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Country | US
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Telephone | 316-990-5157
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | KS
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