Individual
MRS. RUTH E JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3515 BROADWAY AVE, GREAT BEND, KS 67530-3633
(620) 786-6111
Mailing address
1721 POLK ST, GREAT BEND, KS 67530-7514
(620) 786-1466
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-00205
KS
Other
Enumeration date
05/04/2011
Last updated
05/04/2011
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