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General NPI Number Information
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NPI Number | 1932566148
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Entity Type | Organization
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Legal Business Name | GC REHAB LLC
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Dates
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Enumeration Date | 01/19/2016
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Last Update Date | 01/19/2016
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Provider Practice Location Address
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Address Line | 401 E SPRUCE ST
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City | GARDEN CITY
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State | KS
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Zip | 67846-5679
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Country | US
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Telephone | 620-765-1490
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Fax |
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Provider Business Mailing Address
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Address Line | 2520 W RIVERVIEW DR
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City | GARDEN CITY
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State | KS
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Zip | 67846-8838
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NATHAN STRANDMARK
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Credential | D.O.
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Telephone | 620-290-3148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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