Provider Demographics
NPI:1083619175
Name:SELIG, KATHY (PT)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:
Last Name:SELIG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 SE RATNER RD
Mailing Address - Street 2:
Mailing Address - City:BERRYTON
Mailing Address - State:KS
Mailing Address - Zip Code:66409-9312
Mailing Address - Country:US
Mailing Address - Phone:785-271-5533
Mailing Address - Fax:785-271-8818
Practice Address - Street 1:5220 SW 17TH
Practice Address - Street 2:SUITE 130
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-2459
Practice Address - Country:US
Practice Address - Phone:785-271-5533
Practice Address - Fax:785-271-8818
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
KS11-006502251X0800X
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
140722OtherBLUE CROSS
140722OtherBLUE CROSS