Individual
WANDA PERESIC
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1150 N 75TH PL, SUITE 100, KANSAS CITY, KS 66112-3302
(913) 299-7848
(913) 299-7849
Mailing address
1150 N 75TH PL, SUITE 100, KANSAS CITY, KS 66112-3302
(913) 299-7848
(913) 299-7849
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-02927
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28805025
BLUECROSS BLUESHIELD
KS
Enumeration date
07/22/2005
Last updated
07/08/2007
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