Individual
MR. KEITH WENTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
207 W 3RD ST, TONGANOXIE, KS 66086-9763
(913) 680-7754
Mailing address
207 W 3RD ST, TONGANOXIE, KS 66086-9763
(913) 680-7754
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
10/28/2013
Last updated
10/28/2013
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