Individual
THERESA HALLACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
854 N SOCORA ST, WICHITA, KS 67212-3288
(316) 729-6236
Mailing address
335 HUNGERFORD AVE, HAYSVILLE, KS 67060-1543
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-03660
KS
Other
Enumeration date
10/23/2007
Last updated
10/23/2007
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