Provider Demographics
NPI:1346677309
Name:WARDERS, DAVID BERTRAND (CPTA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:BERTRAND
Last Name:WARDERS
Suffix:
Gender:M
Credentials:CPTA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1603 N CHAPEL HILL ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-5506
Mailing Address - Country:US
Mailing Address - Phone:316-440-6551
Mailing Address - Fax:316-440-6560
Practice Address - Street 1:1603 N CHAPEL HILL ST
Practice Address - Street 2:SUITE 400
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-5506
Practice Address - Country:US
Practice Address - Phone:316-440-6551
Practice Address - Fax:316-440-6560
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS14-01340225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant