Provider Demographics
NPI:1316160690
Name:ARK VALLEY PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:ARK VALLEY PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MINKLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:620-442-0255
Mailing Address - Street 1:2524 NORTH SUMMIT
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005
Mailing Address - Country:US
Mailing Address - Phone:620-442-0255
Mailing Address - Fax:
Practice Address - Street 1:2524 N SUMMIT ST
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005-8808
Practice Address - Country:US
Practice Address - Phone:620-442-0255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-01584261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS014747Medicare ID - Type UnspecifiedMEDICARE
KS1700802774Medicare UPIN