Provider Demographics
NPI:1417336280
Name:CORTESE, MICHELLE L (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:L
Last Name:CORTESE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10346 E STONEGATE LN STE 100
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2054
Mailing Address - Country:US
Mailing Address - Phone:316-910-0024
Mailing Address - Fax:316-910-0023
Practice Address - Street 1:10346 E STONEGATE LN STE 100
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2054
Practice Address - Country:US
Practice Address - Phone:316-910-0024
Practice Address - Fax:316-910-0023
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-05096225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist