Provider Demographics
NPI:1528711405
Name:ANYASI, JOSEPH THOMAS (OTR)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:THOMAS
Last Name:ANYASI
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 N CLARENCE AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-1525
Mailing Address - Country:US
Mailing Address - Phone:620-506-7346
Mailing Address - Fax:
Practice Address - Street 1:8338 W 13TH ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-2900
Practice Address - Country:US
Practice Address - Phone:316-729-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-31
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XG0600X
KS17-1528225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology