Individual
TODD ALLEN FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1845 FAIRMOUNT ST, WICHITA, KS 67260-0018
(316) 978-5575
(316) 978-3177
Mailing address
1845 FAIRMOUNT ST, WICHITA, KS 67260-0018
(316) 978-5575
(316) 978-3177
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-00507
KS
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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