Individual
DR. TERRY BONTRAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
3601 N WEBB RD, WICHITA, KS 67226-8129
(316) 630-5350
(316) 630-6349
Mailing address
3601 N WEBB RD, WICHITA, KS 67226-8129
(316) 630-5350
(316) 630-6349
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-12617
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-12617
KANSAS STATE BOARD OF PHARMACY
KS
Enumeration date
03/01/2016
Last updated
03/01/2016
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