Individual
JANELLE FORRISTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10000 W 75TH ST, SUITE 250, MERRIAM, KS 66204-2209
(913) 894-1910
(913) 894-1174
Mailing address
5105 LAKECREST DR, SHAWNEE, KS 66218-9086
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
002241
MO
225X00000X
Occupational Therapist
Primary
17-00880
KS
Other
Enumeration date
11/30/2009
Last updated
11/30/2009
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