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NPI Code Detail

MEDICARE: MS. DANIELLE LYNN REDA P.T.

MEDICARE: MS. DANIELLE LYNN REDA P.T.
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 Therapist11-02674KS

General Provider Information

NPI Number : 1528187598
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DANIELLE LYNN REDA P.T.
Provider Business Mailing Address
First Line : 2551 N PARKDALE CT
Second Line :
City : WICHITA
State : KS
Zip : 67205-6014
Country : US
Telephone Number : 316-773-4462
Fax Number :
Provider Business Practice Location Address
First Line : 9727 E SHANNON WOODS CIR
Second Line : SUITE#160
City : WICHITA
State : KS
Zip : 67226-4102
Country : US
Telephone Number : 316-681-0824
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 07/08/2007

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