Provider Demographics
NPI:1861504755
Name:MATHIS, JEFFREY C (OTD/L,CHT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:C
Last Name:MATHIS
Suffix:
Gender:M
Credentials:OTD/L,CHT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1133 COLLEGE AVE
Mailing Address - Street 2:SUITE G200
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2770
Mailing Address - Country:US
Mailing Address - Phone:785-539-9669
Mailing Address - Fax:785-539-9779
Practice Address - Street 1:1133 COLLEGE AVE
Practice Address - Street 2:SUITE G200
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2770
Practice Address - Country:US
Practice Address - Phone:785-539-9669
Practice Address - Fax:785-539-9779
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS17-00445225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist