Individual
MRS. KIMERLY ANN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3500 N ROCK RD STE 101, WICHITA, KS 67226-1341
(316) 440-3316
Mailing address
200 N POPLAR ST, WHITEWATER, KS 67154-8863
(163) 377-6441
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-00686
KS
Other
Enumeration date
08/08/2018
Last updated
08/08/2018
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