Individual
LAURA KELLERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1615 PARKER AVE, OSAWATOMIE, KS 66064-1703
(913) 755-4165
Mailing address
1615 PARKER AVE, OSAWATOMIE, KS 66064-1703
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1402432
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1402432
KANSA STATE BOARD OF HEALING ARTS
KS
Enumeration date
04/07/2016
Last updated
04/07/2016
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