Individual
JEFFERY TYLER MILLSPAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
1220 WW II MEMORIAL DR, WINFIELD, KS 67156
(620) 221-9479
Mailing address
821 N COVINGTON ST, WICHITA, KS 67212-6526
(316) 215-4719
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4020
KS
Other
Enumeration date
02/11/2020
Last updated
02/11/2020
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