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Individual

MIRANDA LYNN MCCORMACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR L

Contact information

Practice address
2114 N 127TH CT E, WICHITA, KS 67206-3003
(316) 500-8800
Mailing address
7711 W CENTRAL PARK ST, WICHITA, KS 67205-1631
(316) 209-2277

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Enumeration date
03/28/2007
Last updated
04/01/2024
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