MEDICARE: DENISE M BEGNOCHE PT

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	225100000X	Physical Therapist	1100928	KS
2	2251P0200X	Pediatric Physical Therapist	1100928	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	059758	OTHER	KS	BCBS
2	2660	OTHER	KS	PHS

General Provider Information

NPI Number	:	1588751200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE M BEGNOCHE PT

Provider Business Mailing Address
First Line	:	8700 E 29TH STREET NORTH
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67226-2169
Country	:	US
Telephone Number	:	316-634-8710
Fax Number	:	316-634-8850

Provider Business Practice Location Address
First Line	:	8700 E 29TH STREET NORTH
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67226-2169
Country	:	US
Telephone Number	:	316-634-8710
Fax Number	:	316-634-8850

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	08/17/2007

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Directions to “ DENISE M BEGNOCHE PT” Practice Location

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