Organization
WILCOX ADVANCED PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW D WILCOX (OWNER)
(316) 942-5448
Entity
Organization
Contact information
Practice address
2243 S MERIDIAN AVE, WICHITA, KS 67213-1949
(316) 942-5448
(316) 945-5694
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
11-03350
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DQ6270
RAILROAD MEDICARE
—
01
—
KA1554
MEDICARE PTAN
KS
Enumeration date
10/05/2006
Last updated
11/28/2012
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