Kerry Leann Clark
Individual provider Active NPI Physical Therapy Assistant · Chetopa, KS
NPI 1851607162 · NPPES record last updated Aug 24, 2010
Key facts
- NPI
- 1851607162
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 14-01713 (KS)
- Practice address
- 814 Walnut St
Chetopa, KS 67336-8990 - Phone
- (620) 236-7248
- NPI assigned
- Aug 24, 2010
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 14-01713 | KS | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 14-01713 | KS | Yes |
Addresses
Primary practice location
814 Walnut St
Chetopa, KS 67336-8990
Mailing address
1217 S 15TH St
Parsons, KS 67357-5125
Phone (620) 421-2431
Other providers in Chetopa, KS
- Cynthia Ann Brady
- Cah Acquisition Company 2 LLC
- David Wayne Carter
- Chetopa-St. Paul Usd505
- Haskell Regional Hospital, Inc.
- Labette County Medical Center
- Riggs Drugs Inc
- Riggs Drugs Inc
- Kori Kay Ross
All providers in Chetopa, KS · Physical Therapy Assistant in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.