MEDICARE: ALICIA ANN HELFRICH PTA

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	225200000X	Physical Therapy Assistant	14-01781	KS

General Provider Information

NPI Number	:	1851504492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA ANN HELFRICH PTA

Provider Business Mailing Address
First Line	:	PO BOX 92
Second Line	:
City	:	KIOWA
State	:	KS
Zip	:	67070-0092
Country	:	US
Telephone Number	:	620-255-1792
Fax Number	:

Provider Business Practice Location Address
First Line	:	6700 ANTIOCH RD
Second Line	:	#430
City	:	OVERLAND PARK
State	:	KS
Zip	:	66204-1258
Country	:	US
Telephone Number	:	913-652-9229
Fax Number	:

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

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	07/08/2007

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