Individual
NGOC K SERVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1151 N ROCK RD, WICHITA, KS 67206-1262
(316) 634-3600
(316) 634-1141
Mailing address
14912 W SANDWEDGE CT, WICHITA, KS 67235-8009
(316) 634-3600
(316) 634-1141
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-00585
KS
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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