Individual
DR. GRACIA MATLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2010 N 59TH ST, KANSAS CITY, KS 66104-2800
(913) 627-2822
Mailing address
6923 WESTGATE ST, SHAWNEE, KS 66216-2668
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-04816
KS
Other
Enumeration date
09/29/2017
Last updated
09/29/2017
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