Individual
ALICIA MASENTHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2133 S ELIZABETH ST, WICHITA, KS 67213-3403
(316) 262-4473
Mailing address
4850 S SENECA ST, WICHITA, KS 67217-4826
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
11-05090
KS
225100000X
Physical Therapist
Primary
11-05090
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-05090
PT LICENSE
KS
Enumeration date
07/11/2016
Last updated
12/17/2018
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