Individual
ANN B HABERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10100 SHANNON WOODS, WICHITA, KS 67226
(316) 858-1900
(316) 858-1914
Mailing address
10100 SHANNON WOODS, WICHITA, KS 67226
(316) 858-1900
(316) 858-1914
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-01526
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
311810056
TAX ID
KS
Enumeration date
09/13/2010
Last updated
09/13/2010
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