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Individual

MRS. CHASTITY DAWN BRISCOE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.O.T.A

Contact information

Practice address
704 S MAIN ST, HILLSBORO, KS 67063-1530
(620) 897-7796
Mailing address
130 ILLINOIS ST, LITTLE RIVER, KS 67457-9161
(620) 897-7796

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-00358
KS

Other

Enumeration date
02/16/2011
Last updated
02/16/2011
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