Provider Demographics
NPI:1326732264
Name:OPEN RANGE PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:OPEN RANGE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:WARDERS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:316-395-5778
Mailing Address - Street 1:10009 W PRAIRIE WOODS CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209-3909
Mailing Address - Country:US
Mailing Address - Phone:316-395-5778
Mailing Address - Fax:
Practice Address - Street 1:10009 W PRAIRIE WOODS CT
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209-3909
Practice Address - Country:US
Practice Address - Phone:316-395-5778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty