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Individual

MYRIA OAKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT-ATC

Contact information

Practice address
9300 E 29TH ST N, WICHITA, KS 67226-2182
(316) 219-8299
(316) 219-5899
Mailing address
12 LANSDOWNE DR, WICHITA, KS 67220-4907
(316) 650-5279

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2400702
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2400702
KANSAS STATE BOARD OF HEALING ARTS
KS
Enumeration date
09/23/2014
Last updated
09/23/2014
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