Individual
JESSICA LEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
629 S PLUMMER AVE, CHANUTE, KS 66720-1928
(620) 431-4000
Mailing address
629 S PLUMMER AVE, CHANUTE, KS 66720-1928
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-01094
KS
Other
Enumeration date
09/19/2017
Last updated
09/19/2017
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