Individual
JASON KOELLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1143 N MAXWELL ST, MCPHERSON, KS 67460-2728
(620) 755-0420
Mailing address
1143 N MAXWELL ST, MCPHERSON, KS 67460-2728
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
T-03101
KS
Other
Enumeration date
02/06/2012
Last updated
02/06/2012
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