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Individual

MR. SCOTT BRADLEY FIESER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T., CSCS

Contact information

Practice address
2311 S KANSAS RD, NEWTON, KS 67114-9032
(316) 283-7187
(316) 283-7189
Mailing address
200 W DOUGLAS AVE, STE 1040, WICHITA, KS 67202-3013
(316) 263-0003
(316) 263-1241

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-03446
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200269680B
KS
Enumeration date
01/31/2007
Last updated
05/01/2008
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