Individual
MICHELLE WYRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
14188 W 150TH CT, OLATHE, KS 66062-3367
(913) 829-7775
(913) 829-7765
Mailing address
525 N EVERGREEN ST, GARDNER, KS 66030-1819
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251H1300X
Human Factors Physical Therapist
—
—
2251N0400X
Neurology Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37328011
BLUE CROSS BLUE SHIELD
—
05
—
481452209
—
MO
Enumeration date
12/01/2006
Last updated
09/15/2008
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