Provider Demographics
NPI:1447225305
Name:ADVANCE REHABILITATION
Entity type:Organization
Organization Name:ADVANCE REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:HATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-232-9805
Mailing Address - Street 1:6001 SW 6TH AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66615-1011
Mailing Address - Country:US
Mailing Address - Phone:785-232-9805
Mailing Address - Fax:785-232-9806
Practice Address - Street 1:6001 SW 6TH AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615-1011
Practice Address - Country:US
Practice Address - Phone:785-232-9805
Practice Address - Fax:785-232-9806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS646300OtherFIRST GUARD
KS115511OtherBCBS OF KANSAS
KS100320850AMedicaid
KS646300OtherFIRST GUARD