Individual
SHALA M KOELZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
10300 W 103RD ST, SUITE 300, OVERLAND PARK, KS 66214-2642
(913) 894-1910
Mailing address
1922 W FERREL DR, OLATHE, KS 66061-3885
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
KS 1103507
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KS 1103507
STATE LICENSE
KS
Enumeration date
03/30/2007
Last updated
07/19/2007
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