Individual
VICKI DANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1421 W MARLBORO ST, WICHITA, KS 67217-2435
(316) 312-4111
Mailing address
1421 W MARLBORO ST, WICHITA, KS 67217-2435
(316) 312-4111
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200558490A
—
KS
Enumeration date
12/05/2013
Last updated
12/05/2013
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