Organization
PROVIDENCE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD CHRISTOPHER DECK PT (OWNER)
(316) 833-6675
Entity
Organization
Contact information
Practice address
3737 W CENTRAL AVE, WICHITA, KS 67203-4925
(316) 445-0553
(316) 221-2528
Mailing address
10014 W HASKELL CT, WICHITA, KS 67209-3006
(316) 448-0553
(316) 221-2528
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
11-03608
KS
Other
Enumeration date
02/16/2016
Last updated
04/27/2016
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