Individual
LISA THACKERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
10560 BARKLEY ST, SUITE 330, OVERLAND PARK, KS 66212-1811
(913) 652-9229
(913) 652-9198
Mailing address
5607 W 77TH TER, PRAIRIE VILLAGE, KS 66208-4730
(913) 341-7585
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-02908
KS
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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