Individual
MR. KEVYN L SOUPISET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
117 W 6TH ST, LARNED, KS 67550-3045
(620) 285-6011
(620) 285-6012
Mailing address
338 SUNSET RD, GREAT BEND, KS 67530-9255
(620) 285-6011
(620) 285-6012
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-03072
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200547290A
—
KS
Enumeration date
08/09/2006
Last updated
11/10/2008
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