Individual
MR. ALAN WAYNE THAGARD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
550 POPE AVE, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6170
(913) 684-6174
Mailing address
403 N 14TH ST, SABETHA, KS 66534-2113
(785) 284-3132
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002015218
VA
Other
Enumeration date
11/09/2005
Last updated
07/08/2007
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