Bethany A Balzer, PTA

Individual provider Active NPI Physical Therapy Assistant · Wichita, KS

NPI 1750890992 · NPPES record last updated Sep 20, 2017

Key facts

NPI
1750890992
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
1403242 (KS)
Practice address
834 N Socora St Ste 1
Wichita, KS 67212-3279
Phone
(316) 440-3731
Fax
(316) 440-3741
NPI assigned
Sep 20, 2017
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
1403242KSMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1403242 KS Yes

Addresses

Primary practice location

834 N Socora St Ste 1
Wichita, KS 67212-3279

Mailing address

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

Other providers in Wichita, KS

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

Sources for this page

Verify at the official NPI Registry.