Individual
MARY JO VANDYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1637 RILEY ST, ATCHISON, KS 66002-1514
(615) 896-6400
Mailing address
17440 294TH RD, ATCHISON, KS 66002-8274
(913) 367-4627
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-00525
KS
Other
Enumeration date
06/04/2007
Last updated
07/08/2007
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