Individual
MR. THADDEUS M ALEXANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12521 W KENNY CIR, WICHITA, KS 67235-1956
(316) 721-5495
Mailing address
12521 W KENNY CIR, WICHITA, KS 67235-1956
(316) 721-5495
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
01/18/2007
Last updated
07/08/2007
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