Miranda J. Reed, CPTA

Individual provider Active NPI Physical Therapy Assistant · Lyons, KS

NPI 1871831925 · NPPES record last updated Jan 24, 2013

Key facts

NPI
1871831925
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
14-01202 (KS)
Practice address
619 S Clark Ave
Lyons, KS 67554-3003
Phone
(620) 257-7118
Fax
(620) 257-7189
NPI assigned
Jan 24, 2013
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
14-01202KSMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 14-01202 KS Yes

Addresses

Primary practice location

619 S Clark Ave
Lyons, KS 67554-3003

Mailing address

215 W Willow GLN
Hillsboro, KS 67063-1932
Phone (620) 947-0107

Other providers in Lyons, KS

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

Sources for this page

Verify at the official NPI Registry.