Provider Demographics
NPI:1356659494
Name:MARESCH, KENDRA L (CPTA)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:L
Last Name:MARESCH
Suffix:
Gender:F
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:PO BOX 168
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67402-0168
Mailing Address - Country:US
Mailing Address - Phone:785-825-1361
Mailing Address - Fax:785-823-7077
Practice Address - Street 1:521 S SANTA FE AVE STE A
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4162
Practice Address - Country:US
Practice Address - Phone:785-825-1361
Practice Address - Fax:785-823-7077
Is Sole Proprietor?:No
Enumeration Date:2010-09-23
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-017974225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant