Provider Demographics
NPI:1871476036
Name:PIERCE, CARSON LENAE (DPT)
Entity type:Individual
Prefix:
First Name:CARSON
Middle Name:LENAE
Last Name:PIERCE
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 1:9510 W BRITTON ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1429
Mailing Address - Country:US
Mailing Address - Phone:316-258-0369
Mailing Address - Fax:
Practice Address - Street 1:833 N VASSAR AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-2906
Practice Address - Country:US
Practice Address - Phone:430-031-6771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-079132251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology