Individual
ADRIAN MATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1915 FARMSTEAD STREET, WICHITA, KS 67208
(316) 210-1486
Mailing address
1915 FARMSTEAD STREET, WICHITA, KS 67208
(316) 210-1486
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
327642
KS
Other
Enumeration date
10/14/2014
Last updated
10/14/2014
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