Individual
SUDHAGAR GANGATHARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
100 E KANSAS ST, LANSING, KS 66043-1616
(913) 758-0283
Mailing address
4100 S 4TH ST, LEAVENWORTH, KS 66048-5082
(604) 551-2508
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
17-04467
KS
225XG0600X
Gerontology Occupational Therapist
17-04467
KS
225XH1200X
Hand Occupational Therapist
Primary
17-04467
KS
225XL0004X
Low Vision Occupational Therapist
17-04467
KS
225XP0019X
Physical Rehabilitation Occupational Therapist
17-04467
KS
Other
Enumeration date
07/09/2025
Last updated
07/15/2025
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