Individual
ELOISE PENKA DORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
425 N BROADWAY ST, SAINT JOHN, KS 67576-1833
(620) 549-6492
Mailing address
PO BOX 51, SAINT JOHN, KS 67576-0051
(620) 549-6492
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-01132
KS
Other
Enumeration date
04/13/2007
Last updated
07/08/2007
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