Provider Demographics
NPI:1992323638
Name:STRAKA, MATTHEW A
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:A
Last Name:STRAKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12627 E CENTRAL AVE STE 308
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2839
Mailing Address - Country:US
Mailing Address - Phone:316-260-3311
Mailing Address - Fax:
Practice Address - Street 1:3223 N WEBB RD STE 2
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-8176
Practice Address - Country:US
Practice Address - Phone:316-260-3311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist