Individual
RENEE SUPPES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
402 N SANTA FE ST, SAINT JOHN, KS 67576-1800
(615) 896-6400
Mailing address
2400 CHEYENNE DR, GREAT BEND, KS 67530-2437
(620) 791-8677
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
18-00546
KS
Other
Enumeration date
06/04/2007
Last updated
07/08/2007
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