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General NPI Number Information
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NPI Number | 1811273931
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Entity Type | Organization
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Legal Business Name | THERESA A. FLAIGLE
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Dates
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Enumeration Date | 11/02/2011
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Last Update Date | 10/23/2014
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Provider Practice Location Address
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Address Line | 123 N. TYLER RD SUITE 300
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City | WICHITA
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State | KS
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Zip | 67212-3726
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Country | US
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Telephone | 316-869-2220
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Fax | 316-869-2221
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Provider Business Mailing Address
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Address Line | 123 N. TYLER RD. SUITE 300
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City | WICHITA
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State | KS
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Zip | 67212-3726
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Country | US
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Telephone | 316-869-2220
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Fax | 316-869-2221
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JANET SCHWARZ
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Credential |
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Telephone | 316-869-2220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 7543
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License Number State | KS
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