Individual
MADISON R LIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3730 N RIDGE RD STE 500, WICHITA, KS 67205-1233
(316) 440-4901
(316) 440-4904
Mailing address
200 W DOUGLAS AVE STE 1040, WICHITA, KS 67202-3017
(316) 263-0003
(316) 263-1241
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-03875
KS
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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