Provider Demographics
NPI:1285046391
Name:FLUTY, JEFF MICHAEL (ATC, LAT)
Entity type:Individual
Prefix:MR
First Name:JEFF
Middle Name:MICHAEL
Last Name:FLUTY
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005-2662
Mailing Address - Country:US
Mailing Address - Phone:620-441-5270
Mailing Address - Fax:620-441-5355
Practice Address - Street 1:125 S 2ND ST
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005-2662
Practice Address - Country:US
Practice Address - Phone:620-441-5270
Practice Address - Fax:620-441-5355
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-004142255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer