Provider Demographics
NPI:1780992826
Name:SIKO, MARK W (CPTA)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:W
Last Name:SIKO
Suffix:
Gender:M
Credentials:CPTA
Other - Prefix:
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Mailing Address - Street 1:1101 E REPUBLIC AVE
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-5282
Mailing Address - Country:US
Mailing Address - Phone:785-825-1361
Mailing Address - Fax:785-823-7077
Practice Address - Street 1:1101 E REPUBLIC AVE
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-5282
Practice Address - Country:US
Practice Address - Phone:785-825-1361
Practice Address - Fax:785-823-7077
Is Sole Proprietor?:No
Enumeration Date:2010-09-23
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS14-00560225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant