Brooke Nicole Panning

Individual provider Active NPI Physical Therapy Assistant · Ellinwood, KS

NPI 1336786359 · NPPES record last updated Dec 9, 2019

Key facts

NPI
1336786359
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
Practice address
510 W 7TH St
Ellinwood, KS 67526-1101
Phone
(620) 564-2337
NPI assigned
Dec 9, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant
Group: 193400000X SINGLE SPECIALTY GROUP
225200000X Yes

Addresses

Primary practice location

510 W 7TH St
Ellinwood, KS 67526-1101

Mailing address

733 SE 50 Rd
Ellinwood, KS 67526-9241
Phone (620) 617-0937

Other providers in Ellinwood, KS

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

Sources for this page

Verify at the official NPI Registry.