Provider Demographics
NPI:1679997001
Name:SALVE, SHEREE (PT)
Entity type:Individual
Prefix:
First Name:SHEREE
Middle Name:
Last Name:SALVE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 FAIRFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:DODGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67801-2959
Mailing Address - Country:US
Mailing Address - Phone:620-408-4815
Mailing Address - Fax:
Practice Address - Street 1:2200 SUMMERLON CIR STE D
Practice Address - Street 2:
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-2905
Practice Address - Country:US
Practice Address - Phone:620-225-4139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4323225100000X
KS11-04738225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0Medicaid