Kaysha D O'Daniel, PTA

Individual provider Active NPI Physical Therapy Assistant · Independence, KS

NPI 1720567282 · NPPES record last updated Aug 7, 2018

Key facts

NPI
1720567282
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
1402748 (KS)
Practice address
118 W Main St
Independence, KS 67301-3511
Phone
(620) 331-0999
NPI assigned
Aug 7, 2018
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
1402748KSMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1402748 KS Yes

Addresses

Primary practice location

118 W Main St
Independence, KS 67301-3511

Mailing address

200 W Douglas Ave Ste 1040
Wichita, KS 67202-3017
Phone (316) 263-0003

Other providers in Independence, KS

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

Sources for this page

Verify at the official NPI Registry.