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NPI Code Detail

MEDICARE: DR. ROBERT C MANSKE PT, DPT, MED, SCS

MEDICARE: DR. ROBERT C MANSKE PT, DPT, MED, SCS
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 Therapist11-02106KS

General Provider Information

NPI Number : 1790815835
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT C MANSKE PT, DPT, MED, SCS
Provider Business Mailing Address
First Line : 2623 W KEYWEST CT
Second Line :
City : WICHITA
State : KS
Zip : 67204-2323
Country : US
Telephone Number : 316-831-0911
Fax Number :
Provider Business Practice Location Address
First Line : 10100 E SHANNON WOODS ST
Second Line :
City : WICHITA
State : KS
Zip : 67226-4103
Country : US
Telephone Number : 316-219-0253
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2007
Last Update Date : 06/20/2013

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