Individual
MR. WAYNE WILMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
23957 211TH ST, LEAVENWORTH, KS 66048-7688
(913) 250-1821
Mailing address
PO BOX 892, LEAVENWORTH, KS 66048-1099
(913) 250-1821
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
02/08/2007
Last updated
07/09/2007
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