Individual
GRACE T BANACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1921 N WEBB RD, WICHITA, KS 67206-3405
(316) 612-4815
(316) 612-4825
Mailing address
1921 N WEBB RD, WICHITA, KS 67206-3405
(316) 612-4815
(316) 612-4825
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-02374
KS
Other
Enumeration date
05/15/2020
Last updated
04/28/2025
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