Quandaireal Blue, PTA

Individual provider Active NPI Physical Therapy Assistant · Abilene, KS

NPI 1881456895 · NPPES record last updated Jan 25, 2024

Key facts

NPI
1881456895
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
14-04181 (KS)
Practice address
705 N Brady St
Abilene, KS 67410-2113
Phone
(843) 592-6880
NPI assigned
Jan 25, 2024
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
14-04181KSMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 14-04181 KS Yes

Addresses

Primary practice location

705 N Brady St
Abilene, KS 67410-2113

Mailing address

705 N Brady St
Abilene, KS 67410-2113

Other providers in Abilene, KS

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

Sources for this page

Verify at the official NPI Registry.