Provider Demographics
NPI:1952384653
Name:SALINA PHYSICAL THERAPY, LC
Entity Type:Organization
Organization Name:SALINA PHYSICAL THERAPY, LC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:N
Authorized Official - Last Name:DURST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-825-1361
Mailing Address - Street 1:521 S SANTA FE AVE
Mailing Address - Street 2:STE A
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4162
Mailing Address - Country:US
Mailing Address - Phone:785-825-1361
Mailing Address - Fax:785-823-7077
Practice Address - Street 1:521 S SANTA FE AVE
Practice Address - Street 2:STE A
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4162
Practice Address - Country:US
Practice Address - Phone:785-825-1361
Practice Address - Fax:785-823-7077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-28
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100332950AMedicaid
KS115510Medicare ID - Type Unspecified