Provider Demographics
NPI:1578643789
Name:MITCHELL, KATHLYN ARLEEN (LPT)
Entity Type:Individual
Prefix:MRS
First Name:KATHLYN
Middle Name:ARLEEN
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2522 N HIGHPOINT CIRCLE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205
Mailing Address - Country:US
Mailing Address - Phone:316-721-3855
Mailing Address - Fax:
Practice Address - Street 1:215 N LAMAR
Practice Address - Street 2:HAYSVILLE HEALTHCARE CENTER
Practice Address - City:HAYSVILLE
Practice Address - State:KS
Practice Address - Zip Code:67060
Practice Address - Country:US
Practice Address - Phone:316-524-0257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1100669225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist