Provider Demographics
NPI:1265676498
Name:SUDBECK, CURTIS ALAN (DPT, ATC)
Entity Type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:ALAN
Last Name:SUDBECK
Suffix:
Gender:M
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 COMMUNITY DR
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:KS
Mailing Address - Zip Code:66538-9739
Mailing Address - Country:US
Mailing Address - Phone:785-336-6107
Mailing Address - Fax:785-336-0142
Practice Address - Street 1:1600 COMMUNITY DR
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:KS
Practice Address - Zip Code:66538-9739
Practice Address - Country:US
Practice Address - Phone:853-366-1077
Practice Address - Fax:785-336-0142
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-01
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2635225100000X
KS11-03644225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist