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Individual

BRIAN P MICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
4700 INDIAN CREEK PKWY, OVERLAND PARK, KS 66207-4068
(417) 207-9868
Mailing address
12717 W 57TH TER, SHAWNEE, KS 66216-1608
(316) 519-8142

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
T-03741
KS
225X00000X
Occupational Therapist
Primary
18-0097
KS

Other

Enumeration date
09/20/2013
Last updated
05/27/2021
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