Organization
FIRST STREET REHAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DWIGHT NEIL HUSTON PTA (PRESIDENT)
(620) 549-3757
Entity
Organization
Contact information
Practice address
607 E 1ST AVE, ST JOHN, KS 67576-2223
(620) 549-3757
Mailing address
607 E 1ST AVE, PO BOX 14, ST JOHN, KS 67576-2223
(620) 549-3757
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-00777
KS
Other
Enumeration date
11/09/2005
Last updated
08/22/2020
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