Individual
MR. ETHAN WILMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
2800 CLAY EDWARDS DR, NORTH KANSAS CITY, MO 64116-3220
(816) 691-1795
Mailing address
1800 WALNUT ST APT 409, KANSAS CITY, MO 64108-2783
(808) 640-4635
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
2021000498
MO
Other
Enumeration date
03/20/2025
Last updated
03/20/2025
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