MEDICARE: SUSAN E KEENE

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	1102260	KS

General Provider Information

NPI Number	:	1861631756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN E KEENE

Provider Business Mailing Address
First Line	:	10100 SHANNON WOODS ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67226-4103
Country	:	US
Telephone Number	:	316-858-1900
Fax Number	:

Provider Business Practice Location Address
First Line	:	10100 SHANNON WOODS ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67226-4103
Country	:	US
Telephone Number	:	316-858-1900
Fax Number	:

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

Provider Enumeration Date	:	02/17/2009
Last Update Date	:	05/11/2026

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Directions to “ SUSAN E KEENE ” Practice Location

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