Provider Demographics
NPI:1760976716
Name:GRABOWSKI, TAYLOR LYN (DPT)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:LYN
Last Name:GRABOWSKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:LYN
Other - Last Name:SEXTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 W DOUGLAS AVE STE 1040
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-3017
Mailing Address - Country:US
Mailing Address - Phone:316-263-0003
Mailing Address - Fax:316-263-1241
Practice Address - Street 1:712 1ST TER STE 103
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:KS
Practice Address - Zip Code:66043-1735
Practice Address - Country:US
Practice Address - Phone:913-727-2022
Practice Address - Fax:913-727-2033
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-21
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-5957225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS11-5957OtherLICENSE