Organization
OSTEOPRACTIC PHYSICAL THERAPY CLINIC OF WICHITA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REINE NOLA DPT (OWNER)
(316) 779-4110
Entity
Organization
Contact information
Practice address
804 S OLIVER AVE, WICHITA, KS 67218-2329
(316) 779-4110
(316) 330-7019
Mailing address
9 N CYPRESS DR, WICHITA, KS 67206-2501
(316) 304-1924
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201357980A
—
KS
Enumeration date
03/11/2022
Last updated
02/04/2025
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