Provider Demographics
NPI:1992060339
Name:DAKIN, LETITIA M (DPT)
Entity type:Individual
Prefix:
First Name:LETITIA
Middle Name:M
Last Name:DAKIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7550 W VILLAGE CIR
Mailing Address - Street 2:STE. 1
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-9363
Mailing Address - Country:US
Mailing Address - Phone:316-838-2020
Mailing Address - Fax:316-838-7574
Practice Address - Street 1:7550 W VILLAGE CIR
Practice Address - Street 2:STE. 1
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-9363
Practice Address - Country:US
Practice Address - Phone:316-838-2020
Practice Address - Fax:316-838-7574
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-04191225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist