Individual
LAURIE GORACKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
601 CROSS ST, BURLINGTON, KS 66839-1105
(620) 364-2117
Mailing address
805 N C ST, LE ROY, KS 66857-9522
(620) 228-3127
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1801001
KS
Other
Enumeration date
05/05/2016
Last updated
03/29/2022
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