Basic Information
Provider Information
NPI: 1467747881
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRUBLE
FirstName: ANDREW
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5220 SW 17TH
Address2: SUITE 130
City: TOPEKA
State: KS
PostalCode: 666042500
CountryCode: US
TelephoneNumber: 7852715533
FaxNumber: 7852718818
Practice Location
Address1: 5220 SW 17TH
Address2: SUITE 130
City: TOPEKA
State: KS
PostalCode: 666042500
CountryCode: US
TelephoneNumber: 7852715533
FaxNumber: 7852718818
Other Information
ProviderEnumerationDate: 06/14/2011
LastUpdateDate: 06/14/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XT02981KSY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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