Organization
ADVANCED PT COFFEYVILLE LLC
Active
Other names
Advanced PT Coffeyville
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID C TODD P.T. (P.T./OWNER)
(316) 260-6869
Entity
Organization
Contact information
Practice address
2205 W 8TH ST, COFFEYVILLE, KS 67337-2936
(620) 251-5839
(620) 251-5839
Mailing address
200 W DOUGLAS, STE 1040, WICHITA, KS 67202-3017
(316) 263-0003
(316) 263-1241
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-00261
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD2834
RAILROAD MEDICARE
KS
Enumeration date
07/05/2006
Last updated
01/17/2008
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