Individual
MICHAEL TOREY SHACKELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
9920 E HARRY ST, WICHITA, KS 67207-5008
(316) 265-4295
Mailing address
25100 W INDIAN RIDGE CT, ANDALE, KS 67001-9741
(316) 617-0660
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1701301
KS
Other
Enumeration date
08/17/2023
Last updated
08/17/2023
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