Individual
JENNIFER GOTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
10000 W 75TH ST, STE. 250, MERRIAM, KS 66204-2209
(888) 913-1910
Mailing address
10000 W 75TH ST, STE. 250, MERRIAM, KS 66204-2209
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2016027659
MO
Other
Enumeration date
09/23/2016
Last updated
09/23/2016
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