Basic Information
| Provider Information | |||||||||
| NPI: | 1245784800 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARTLEY | ||||||||
| FirstName: | KRISTY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5220 SW 17TH ST | ||||||||
| Address2: | SUITE 130 | ||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666042500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852319166 | ||||||||
| FaxNumber: | 7852718818 | ||||||||
| Practice Location | |||||||||
| Address1: | 5220 SW 17TH ST | ||||||||
| Address2: | SUITE 130 | ||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666042500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852319166 | ||||||||
| FaxNumber: | 7852718818 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2016 | ||||||||
| LastUpdateDate: | 08/11/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 11-05466 | KS | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.