Individual
VICKI L GROMALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1861 N. ROAD ROAD, SUITE 105, WICHITA, KS 67206-1264
(316) 201-1202
(316) 201-1251
Mailing address
1861 N. ROAD ROAD, SUITE 105, WICHITA, KS 67206-1264
(316) 201-1202
(316) 201-1251
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1500730
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100384150L
—
KS
Enumeration date
12/18/2006
Last updated
01/15/2013
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