Provider Demographics
NPI:1558920140
Name:JAHNEL, ADAM ROBERT (DPT)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:ROBERT
Last Name:JAHNEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 OREGON ST
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:KS
Mailing Address - Zip Code:66434-2205
Mailing Address - Country:US
Mailing Address - Phone:785-742-2201
Mailing Address - Fax:785-742-2202
Practice Address - Street 1:819 OREGON ST
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:KS
Practice Address - Zip Code:66434-2205
Practice Address - Country:US
Practice Address - Phone:785-742-2201
Practice Address - Fax:785-742-2202
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-06127225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS11-06127OtherPHYSICAL THERAPY LICENSE