Individual
MR. GERARDO IVAN ESPINO SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
3636 NORTH RIDGE, WICHITA, KS 67205-9402
(316) 462-3636
Mailing address
3636 N RIDGE RD, WICHITA, KS 67205-1213
(316) 462-3636
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1800783
KS
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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