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General NPI Number Information
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NPI Number | 1972588499
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Entity Type | Individual
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Provider Name | STEVEN WILSON VEQUIST PT
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Gender | Male
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 05/09/2017
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Provider Practice Location Address
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Address Line | 11120 E 26TH ST N
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City | WICHITA
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State | KS
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Zip | 67226-4548
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Country | US
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Telephone | 316-858-1177
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Fax |
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Provider Business Mailing Address
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Address Line | 2551 N PARKDALE CT
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City | WICHITA
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State | KS
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Zip | 67205-6014
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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 |
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Name |
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Credential |
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Telephone |
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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 | 11-00996
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License Number State | KS
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