Provider Demographics
NPI:1720503915
Name:RICE, KERBY (PT)
Entity Type:Individual
Prefix:
First Name:KERBY
Middle Name:
Last Name:RICE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2514 VINE ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2476
Mailing Address - Country:US
Mailing Address - Phone:785-621-5888
Mailing Address - Fax:785-621-5890
Practice Address - Street 1:2514 VINE ST UNIT 2
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2476
Practice Address - Country:US
Practice Address - Phone:785-621-5888
Practice Address - Fax:785-621-5890
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-05419208100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation