Provider Demographics
NPI:1881677276
Name:PRO-FIT PHYSICAL THERAPY CENTER
Entity Type:Organization
Organization Name:PRO-FIT PHYSICAL THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:NEU
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:785-842-3444
Mailing Address - Street 1:1072 N 1950 RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-9040
Mailing Address - Country:US
Mailing Address - Phone:785-842-3444
Mailing Address - Fax:785-842-3410
Practice Address - Street 1:2100 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:KS
Practice Address - Zip Code:67357-4951
Practice Address - Country:US
Practice Address - Phone:620-421-2159
Practice Address - Fax:620-421-2195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS115631Medicare ID - Type Unspecified