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NPI Code Detail

MEDICARE: CASSANDRA REGINE MAINS PT, DPT

MEDICARE:   CASSANDRA REGINE MAINS  PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist11-04099KS

General Provider Information

NPI Number : 1164742052
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA REGINE MAINS PT, DPT
Provider Business Mailing Address
First Line : 504 COLLEGE ST
Second Line :
City : HALSTEAD
State : KS
Zip : 67056-2137
Country : US
Telephone Number : 316-835-0042
Fax Number : 316-669-8502
Provider Business Practice Location Address
First Line : 232 MAIN ST
Second Line :
City : HALSTEAD
State : KS
Zip : 67056-1913
Country : US
Telephone Number : 316-835-0042
Fax Number : 316-669-8502
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2010
Last Update Date : 09/10/2021

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Directions to “ CASSANDRA REGINE MAINS PT, DPT” Practice Location

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