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General NPI Number Information
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NPI Number | 1760785489
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Entity Type | Organization
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Legal Business Name | NEISH INSTITUTE LLC
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Dates
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Enumeration Date | 12/20/2010
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Last Update Date | 12/20/2010
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Provider Practice Location Address
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Address Line | 3460 N RIDGE RD SUITE 80
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City | WICHITA
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State | KS
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Zip | 67205-1222
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Country | US
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Telephone | 316-722-8888
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Fax | 316-722-8881
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Provider Business Mailing Address
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Address Line | 3460 N RIDGE RD SUITE 80
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City | WICHITA
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State | KS
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Zip | 67205-1222
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Country | US
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Telephone | 316-722-8888
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Fax | 316-722-8881
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Authorized Official
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Title or Position | CEO
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Name | MS. DIANE M GAGE
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Credential |
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Telephone | 316-722-8888
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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 | 11-02679
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License Number State | KS
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