Individual
RON WOLLENHAUPT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
2012 10TH AVE, LEAVENWORTH, KS 66048-4207
(913) 684-1550
Mailing address
9212 LICHTENAUER DR, APT 539, LENEXA, KS 66219-2101
(913) 406-2032
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-00176
KS
Other
Enumeration date
02/22/2017
Last updated
02/22/2017
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