Individual
DWIGHT EDWARD CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
600 NW PRYOR RD, LEES SUMMIT, MO 64081-1104
(816) 347-2400
Mailing address
1408 SE 7TH ST, LEES SUMMIT, MO 64063-6137
(913) 209-9524
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2017025259
MO
Other
Enumeration date
01/16/2024
Last updated
01/16/2024
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