Type 1 Provider

LBN: Type 1 Provider
Type 1 Provider is an health care organization with primary practice located at 2520 Crestline Pl , Lawrence KS 66047-2865. The organization recently has only one registered license in Ambulatory Health Care Facilities / Physical Therapy, which is considered as the primary health care specialty. Type 1 Provider can be contacted via phone (785) 979-2145, or through Roberson, Anthony via phone (785) 979-2145.

Contact Information

Primary practice address
2520 Crestline Pl Lawrence KS 66047-2865
Fax:
Website:
Authorized official contact:
Name: Roberson, Anthony Physical Therapist Assistant (PTA)

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Physical Therapy 261QP2000X

Profile Details

NPI number 1548697493
LBN Legal business name Type 1 Provider
DBA Doing business as
Authorized official Roberson, Anthony Physical Therapist Assistant (PTA)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 7th, 2013
Last updated Oct 7th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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