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General NPI Number Information
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NPI Number | 1790854701
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Entity Type | Individual
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Provider Name | BRENT MELROY PT
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Gender | Male
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4940 W. 137TH ST.
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City | LEAWOOD
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State | KS
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Zip | 66224-6622
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Country | US
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Telephone | 913-232-9846
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Fax | 913-232-9817
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Provider Business Mailing Address
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Address Line | 12112 W KELLOGG ST
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City | WICHITA
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State | KS
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Zip | 67235-1100
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Country | US
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Telephone | 316-440-1100
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Fax | 316-440-1089
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 11-03653
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License Number State | KS
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