Individual
LISA BETH BOOKTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
850 S ERIE ST, WICHITA, KS 67211-2907
(316) 847-2812
Mailing address
850 S ERIE ST, WICHITA, KS 67211-2907
(316) 847-2812
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-00174
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14-00174
—
KS
Enumeration date
01/03/2017
Last updated
01/03/2017
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