Provider Demographics
NPI:1912999590
Name:PHYSICAL THERAPY PLUS PA
Entity Type:Organization
Organization Name:PHYSICAL THERAPY PLUS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:K
Authorized Official - Last Name:FRYE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:785-825-2911
Mailing Address - Street 1:1000 ELMHURST BLVD
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-7404
Mailing Address - Country:US
Mailing Address - Phone:785-825-2911
Mailing Address - Fax:785-825-2912
Practice Address - Street 1:1000 ELMHURST BLVD
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-7404
Practice Address - Country:US
Practice Address - Phone:785-825-2911
Practice Address - Fax:785-825-2912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1100700225100000X
KS1102391225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
115669OtherBC BS
140916Medicare ID - Type Unspecified
115669OtherBC BS