Provider Demographics
NPI:1033515861
Name:HUMPHREYS, SETH S (CPTA)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:S
Last Name:HUMPHREYS
Suffix:
Gender:M
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 UPPER MILL HEIGHTS DR APT A3
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-3319
Mailing Address - Country:US
Mailing Address - Phone:785-825-1361
Mailing Address - Fax:785-823-7077
Practice Address - Street 1:1101 E REPUBLIC AVE
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-5282
Practice Address - Country:US
Practice Address - Phone:785-825-1361
Practice Address - Fax:785-823-7077
Is Sole Proprietor?:No
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-02763225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant