Organization
ICT SPEECH THERAPY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY TYLER MILLSPAUGH (OWNER)
(316) 215-4719
Entity
Organization
Contact information
Practice address
7570 W 21ST ST N, BLDG 1050, STE D, WICHITA, KS 67205-6720
(316) 409-9932
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
—
—
Other
Enumeration date
10/07/2022
Last updated
10/07/2022
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