Individual
SAMUEL AARON INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
7105 MISSION RD, PRAIRIE VILLAGE, KS 66208-3077
(913) 262-1611
Mailing address
12411 W 119TH TER APT 618, OVERLAND PARK, KS 66213-5725
(817) 269-5971
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-04512
KS
225100000X
Physical Therapist
1166119
TX
Other
Enumeration date
04/03/2007
Last updated
03/27/2013
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