Provider Demographics
NPI:1770005332
Name:PK THERAPY LLC
Entity Type:Organization
Organization Name:PK THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:E
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:785-594-3746
Mailing Address - Street 1:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:BALDWIN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66006-0215
Mailing Address - Country:US
Mailing Address - Phone:785-594-3746
Mailing Address - Fax:
Practice Address - Street 1:491 E 1814TH RD
Practice Address - Street 2:
Practice Address - City:BALDWIN CITY
Practice Address - State:KS
Practice Address - Zip Code:66006
Practice Address - Country:US
Practice Address - Phone:785-594-3746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-14
Last Update Date:2017-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-00449225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty