Provider Demographics
NPI:1154947984
Name:TANKING, KARA ANN (DPT)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:ANN
Last Name:TANKING
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12085 214TH RD
Mailing Address - Street 2:
Mailing Address - City:HOLTON
Mailing Address - State:KS
Mailing Address - Zip Code:66436-8085
Mailing Address - Country:US
Mailing Address - Phone:785-817-7112
Mailing Address - Fax:
Practice Address - Street 1:6001 SW 6TH AVE STE 230
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615-1004
Practice Address - Country:US
Practice Address - Phone:785-232-9805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-06444225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist