Kelli Ingmire

Individual provider Active NPI Physical Therapy Assistant · Gardner, KS

NPI 1306045828 · NPPES record last updated Jul 13, 2007

Key facts

NPI
1306045828
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
T01260 (KS)
Practice address
223 Bedford St
Gardner, KS 66030-1185
Phone
(615) 896-6400
NPI assigned
Jul 13, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
T01260KSMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X T01260 KS Yes

Addresses

Primary practice location

223 Bedford St
Gardner, KS 66030-1185

Mailing address

3453 SW Burlingame Rd
Topeka, KS 66611-4017
Phone (785) 845-4415

Other providers in Gardner, KS

All providers in Gardner, KS · Physical Therapy Assistant in Kansas

Sources for this page

Verify at the official NPI Registry.