Provider Demographics
NPI:1750697959
Name:BEYER, LINDA L (CPTA)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:BEYER
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 N TYLER RD
Mailing Address - Street 2:STE. 100
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-3265
Mailing Address - Country:US
Mailing Address - Phone:316-773-0909
Mailing Address - Fax:316-773-0606
Practice Address - Street 1:940 N TYLER RD
Practice Address - Street 2:STE. 100
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-3265
Practice Address - Country:US
Practice Address - Phone:316-773-0909
Practice Address - Fax:316-773-0606
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00891225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1750697959OtherNPI
204184281OtherTIN