Individual
CHARLY NEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
777 N MCLEAN BLVD, WICHITA, KS 67203-4980
(316) 942-7000
Mailing address
1065 E KARLA AVE, HAYSVILLE, KS 67060-1860
(253) 389-4284
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-02141
KS
Other
Enumeration date
07/22/2013
Last updated
07/22/2013
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