Individual
IVAN VILLAGRANA-FRAIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6400 GLENWOOD ST STE 111, OVERLAND PARK, KS 66202-4014
(913) 831-2721
Mailing address
6201 LONGWOOD AVE, KANSAS CITY, KS 66104-1942
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14--02-995
KS
Other
Enumeration date
03/23/2016
Last updated
03/23/2016
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