Individual
QUANDAIREAL BLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
705 N BRADY ST, ABILENE, KS 67410-2113
(843) 592-6880
Mailing address
705 N BRADY ST, ABILENE, KS 67410-2113
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-04181
KS
Other
Enumeration date
01/25/2024
Last updated
01/25/2024
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