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Individual

DONITA HOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
622 N. EDGEMOOR ST., WICHITA, KS 67208
(316) 686-5100
(316) 686-3993
Mailing address
11190 SW SANTA FE LAKE RD, AUGUSTA, KS 67010
(316) 409-9501

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-00858
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1891742573
KS
Enumeration date
09/05/2017
Last updated
09/05/2017
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