Richard Wayne Dinneen, PTA

Individual provider Active NPI Physical Therapy Assistant · Saint Marys, KS

NPI 1881082014 · NPPES record last updated Dec 22, 2014

Key facts

NPI
1881082014
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
14-01953 (KS)
Practice address
203 E Lasley St
Saint Marys, KS 66536-1739
Phone
(785) 437-2008
NPI assigned
Dec 22, 2014
Sex
Male
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

State licenses

LicenseStateTypeSpecialty
14-01953KSMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 14-01953 KS Yes

Addresses

Primary practice location

203 E Lasley St
Saint Marys, KS 66536-1739

Mailing address

203 E Lasley St
Saint Marys, KS 66536-1739
Phone (785) 437-2008

Other providers in Saint Marys, KS

All providers in Saint Marys, KS · Physical Therapy Assistant in Kansas

Sources for this page

Verify at the official NPI Registry.