Individual
JANICE CAROLLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11611 GRANADA LANE, LEAWOOD, KS 66211
(913) 906-0200
Mailing address
5412 W 163RD CT, OVERLAND PARK, KS 66085-7815
(913) 940-4573
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-00701
KS
Other
Enumeration date
07/16/2018
Last updated
07/16/2018
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