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General NPI Number Information
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NPI Number | 1962670588
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Entity Type | Organization
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Legal Business Name | PENTAGON PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 02/16/2008
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Last Update Date | 02/16/2008
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Provider Practice Location Address
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Address Line | 228 S MAIN ST
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City | MCPHERSON
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State | KS
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Zip | 67460-4844
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Country | US
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Telephone | 620-755-5272
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 305
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City | MCPHERSON
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State | KS
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Zip | 67460-0305
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Country | US
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Telephone | 620-755-5272
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | SCOTT K HOHMANN
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Credential | P.T.
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Telephone | 620-755-5272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1102862
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License Number State | KS
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