Provider Demographics
NPI:1619971124
Name:VOOS, BRIAN ALAN (PT)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:ALAN
Last Name:VOOS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 OREGON ST
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:KS
Mailing Address - Zip Code:66434-2232
Mailing Address - Country:US
Mailing Address - Phone:785-742-7606
Mailing Address - Fax:785-742-4490
Practice Address - Street 1:700 OREGON ST
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:KS
Practice Address - Zip Code:66434-2232
Practice Address - Country:US
Practice Address - Phone:785-742-7606
Practice Address - Fax:785-742-4490
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1102759225100000X
NE2223225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS140647Medicare ID - Type UnspecifiedPHYSICAL THERAPIST