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General NPI Number Information
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NPI Number | 1912598681
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE CENTER FOR THERAPY P.A.
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Dates
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Enumeration Date | 01/26/2021
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | 223 S HILLSIDE ST
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City | WICHITA
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State | KS
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Zip | 67211-2128
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Country | US
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Telephone | 316-691-8885
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Fax | 316-691-8866
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Provider Business Mailing Address
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Address Line | 223 S HILLSIDE ST
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City | WICHITA
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State | KS
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Zip | 67211-2128
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Country | US
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Telephone | 316-260-3934
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTEN FIELDS
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Credential | DPT
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Telephone | 316-260-3934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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