Provider Demographics
NPI:1861861676
Name:PRABHU, ARCHANA (PT)
Entity Type:Individual
Prefix:MS
First Name:ARCHANA
Middle Name:
Last Name:PRABHU
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 SW FAIRLAWN RD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-2338
Mailing Address - Country:US
Mailing Address - Phone:785-228-1700
Mailing Address - Fax:785-273-0716
Practice Address - Street 1:801 SW FAIRLAWN RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-2338
Practice Address - Country:US
Practice Address - Phone:785-228-1700
Practice Address - Fax:785-273-0716
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-05211225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist