Individual
MRS. TYRA JEAN WOLFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
2830 N TEE TIME, WICHITA, KS 67205-1628
(316) 729-9756
Mailing address
2830 N TEE TIME, WICHITA, KS 67205-1628
(316) 729-9756
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-00089
KS
Other
Enumeration date
07/02/2010
Last updated
07/02/2010
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