Individual
GREGORY KYLE HERRENBRUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6620 BALLENTINE ST, SHAWNEE, KS 66203-3824
(913) 484-0790
Mailing address
6620 BALLENTINE ST, SHAWNEE, KS 66203-3824
(913) 484-0790
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
06/04/2012
Last updated
06/04/2012
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