Individual
LYNLEA DAWN SOUTHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8700 E 29TH ST N, WICHITA, KS 67226-2169
(316) 634-8710
(316) 634-8891
Mailing address
803 OLD FARM ESTATES RD APT A, HUTCHINSON, KS 67502-3487
(316) 634-8710
(316) 634-8891
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/20/2014
Last updated
06/20/2014
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