Organization
NORTHWEST KANSAS PHYSICAL THERAPY, LLC
Active
Organization
NORTHWEST KANSAS PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAWN LARAE STEPHENS PT (PHYSICAL THERAPIST/OWNER)
(785) 415-2378
Entity
Organization
Contact information
Practice address
421 MAIN ST, STOCKTON, KS 67669-1929
(785) 415-2378
(785) 415-2379
Mailing address
421 MAIN ST, STOCKTON, KS 67669-1929
(785) 415-2378
(785) 415-2379
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LLC NO. 3598190
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100319840B
—
KS
01
—
115633
BLUE CROSS/BLUE SHIELD
KS
01
—
590460
1ST GUARD.
KS
01
—
DC6764
RAILROAD MEDICARE
KS
Enumeration date
08/02/2005
Last updated
04/04/2013
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