Individual
THEODORE FREMONT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
260 N ROCK RD STE 150, WICHITA, KS 67206-2269
(316) 685-9200
Mailing address
260 N ROCK RD STE 150, WICHITA, KS 67206-2269
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
227
KS
Other
Enumeration date
09/13/2006
Last updated
07/08/2007
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