Individual
JULIE A WITTUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
122 S NEOSHO, CHERRYVALE, KS 67335
(620) 325-2253
Mailing address
5090 OAK TREE LN, NEODESHA, KS 66757-1624
(620) 305-8002
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-02349
KS
Other
Enumeration date
08/05/2013
Last updated
01/13/2014
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