Provider Demographics
NPI:1942200951
Name:PADFIELD, MARK J (ATC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:J
Last Name:PADFIELD
Suffix:
Gender:M
Credentials:ATC
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Mailing Address - Street 1:404 E HIGHWAY 24-40
Mailing Address - Street 2:
Mailing Address - City:TONGANOXIE
Mailing Address - State:KS
Mailing Address - Zip Code:66086-9505
Mailing Address - Country:US
Mailing Address - Phone:913-845-2654
Mailing Address - Fax:913-845-3716
Practice Address - Street 1:404 E HIGHWAY 24-40
Practice Address - Street 2:
Practice Address - City:TONGANOXIE
Practice Address - State:KS
Practice Address - Zip Code:66086-9505
Practice Address - Country:US
Practice Address - Phone:913-845-2654
Practice Address - Fax:913-845-3716
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS24-004302255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer