Provider Demographics
NPI:1528492345
Name:BESSER, TREBOR RAY (PT)
Entity type:Individual
Prefix:MR
First Name:TREBOR
Middle Name:RAY
Last Name:BESSER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 W DOUGLAS AVE STE 1040
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-3017
Mailing Address - Country:US
Mailing Address - Phone:316-263-0003
Mailing Address - Fax:316-263-1241
Practice Address - Street 1:1725 E DOUGLAS AVE STE 103
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-1610
Practice Address - Country:US
Practice Address - Phone:316-202-0987
Practice Address - Fax:316-202-0988
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS11-04663225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist