Individual
LACEY MICHELLE DEARMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
1603 N CHAPEL HILL ST, WICHITA, KS 67206-5506
(316) 440-6551
Mailing address
1965 N STONEY POINT CT, WICHITA, KS 67212-6498
(316) 393-0563
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-01530
KS
Other
Enumeration date
09/18/2013
Last updated
09/18/2013
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