Individual
JENNIFER LYN DILLAVOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPTA
Contact information
Practice address
10000 W 75TH ST, SUITE 750, MERRIAM, KS 66204-2209
(913) 894-1910
Mailing address
10000 W 75TH ST, SUITE 750, MERRIAM, KS 66204-2209
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
117074
MO
225200000X
Physical Therapy Assistant
Primary
14-01037
KS
Other
Enumeration date
04/07/2010
Last updated
04/07/2010
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