Organization
ADVANCED PT LLC
Active
Other names
Preferred PT Cherry Lane
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID C TODD PT (OWNER)
(316) 260-6869
Entity
Organization
Contact information
Practice address
1640 W CHERRY LN, STE 120, MERIDIAN, ID 83642-8187
(208) 855-2099
(208) 855-2155
Mailing address
200 W DOUGLAS AVE, STE 1040, WICHITA, KS 67202-3017
(316) 263-0003
(316) 263-1241
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG5887
RETIRED RAILROAD MEDICARE
ID
Enumeration date
11/21/2006
Last updated
02/19/2008
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