Provider Demographics
NPI:1104132562
Name:ATWELL, TREVA IRENE (CPTA)
Entity type:Individual
Prefix:
First Name:TREVA
Middle Name:IRENE
Last Name:ATWELL
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:631 E CRAWFORD ST STE 220
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-5116
Mailing Address - Country:US
Mailing Address - Phone:785-825-2323
Mailing Address - Fax:785-825-2325
Practice Address - Street 1:631 E CRAWFORD ST STE 220
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-5116
Practice Address - Country:US
Practice Address - Phone:785-825-2323
Practice Address - Fax:785-825-2325
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00101225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant