=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902566672
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GOODLIFE PHYSICAL THERAPY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2021
-----------------------------------------------------
Last Update Date | 08/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 250 N SANTA FE AVE STE D
-----------------------------------------------------
City | SALINA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67401-2321
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-236-8344
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 311 HOUSTON ST STE E
-----------------------------------------------------
City | MANHATTAN
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66502-6171
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PHYSICAL THERAPIST
-----------------------------------------------------
Name | ROXANNE ROBERTS
-----------------------------------------------------
Credential | DPT
-----------------------------------------------------
Telephone | 785-236-8344
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------