Individual
TRACI JO VANDEWEERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3715 SW 29TH ST, TOPEKA, KS 66614-2107
(785) 354-0767
Mailing address
1605 SYCAMORE ST, EUDORA, KS 66025-8901
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-01807
KS
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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