Individual
MICHELLE MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4500 W 107TH ST, OVERLAND PARK, KS 66207-4025
(913) 341-9880
Mailing address
17337 JENNIFER ST, GARDNER, KS 66030-9211
(913) 884-7942
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2400382
LICENSE
KS
Enumeration date
08/30/2006
Last updated
07/08/2007
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