Ict Speech Therapy Services Llc | |
7570 W 21st St N, Bldg 1050, Ste D, Wichita, KS 67205-6720 | |
(316) 409-9932 | |
Not Available |
Full Name | Ict Speech Therapy Services Llc |
---|---|
Type | Facility |
Speciality | Speech-language Pathologist |
Location | 7570 W 21st St N, Wichita, Kansas |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1669197141 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | (* (Not Available)) | Primary |
Provider Name | Jeffery Tyler Millspaugh |
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Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1669004230 PECOS PAC ID: 8123495330 Enrollment ID: I20221101001547 |
Mailing Address | Practice Location Address |
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Ict Speech Therapy Services Llc 821 N Covington St, Wichita, KS 67212-6526 Ph: (316) 215-4719 | Ict Speech Therapy Services Llc 7570 W 21st St N, Bldg 1050, Ste D, Wichita, KS 67205-6720 Ph: (316) 409-9932 |
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Trisha L Bosken, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 340 S Broadway St, Wichita, KS 67202 Phone: 316-267-5437 Fax: 316-267-5444 | |
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