Provider Demographics
NPI:1235784570
Name:JARVIS, HALEY (DPT)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:JARVIS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 PENN DR
Mailing Address - Street 2:
Mailing Address - City:MCPHERSON
Mailing Address - State:KS
Mailing Address - Zip Code:67460-1717
Mailing Address - Country:US
Mailing Address - Phone:620-755-3492
Mailing Address - Fax:
Practice Address - Street 1:1000 HOSPITAL DRIVE, BUILDING 4
Practice Address - Street 2:
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460-2700
Practice Address - Country:US
Practice Address - Phone:620-241-4321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-05
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-064782251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic