MEDICARE: PHYSICAL & RESPIRATORY THERAPY SERVICES LLC

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
1	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407850902
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICAL & RESPIRATORY THERAPY SERVICES LLC

Provider Business Mailing Address
First Line	:	819 OREGON ST
Second Line	:
City	:	HIAWATHA
State	:	KS
Zip	:	66434-2205
Country	:	US
Telephone Number	:	785-742-2201
Fax Number	:	785-742-2202

Provider Business Practice Location Address
First Line	:	819 OREGON ST
Second Line	:
City	:	HIAWATHA
State	:	KS
Zip	:	66434-2205
Country	:	US
Telephone Number	:	785-742-2201
Fax Number	:	785-742-2202

Authorized Official
Title or Position	:	CFO/VICE PRESIDENT
Name	:	MR. DARRELL A METCALF
Credential	:
Telephone Number	:	800-334-6027

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	05/11/2020

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