Provider Demographics
NPI:1932489804
Name:JOANNA L RUNGE R P T P A
Entity Type:Organization
Organization Name:JOANNA L RUNGE R P T P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUNGE
Authorized Official - Suffix:
Authorized Official - Credentials:LPT
Authorized Official - Phone:316-295-9226
Mailing Address - Street 1:310 MORNINGSIDE LN
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-1347
Mailing Address - Country:US
Mailing Address - Phone:316-295-9226
Mailing Address - Fax:
Practice Address - Street 1:301 N MAIN ST STE 202A
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-3460
Practice Address - Country:US
Practice Address - Phone:316-295-9226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-24
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-01278225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty