Provider Demographics
NPI:1023013463
Name:FRANZ, JAY (PT)
Entity Type:Individual
Prefix:MR
First Name:JAY
Middle Name:
Last Name:FRANZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1948 S CRESTLINE AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209-3902
Mailing Address - Country:US
Mailing Address - Phone:316-722-7929
Mailing Address - Fax:316-630-0390
Practice Address - Street 1:8620 E 34TH ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2601
Practice Address - Country:US
Practice Address - Phone:316-630-0388
Practice Address - Fax:316-630-0390
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-02091225100000X
2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
140388OtherBLUE CROSS
140388Medicare ID - Type Unspecified