Individual
BETH MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
707 N EMPORIA ST, WICHITA, KS 67214-3707
(316) 858-3524
Mailing address
1451 N WOODLAND ST, WICHITA, KS 67203-2735
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
24-00665
KS
Other
Enumeration date
06/26/2014
Last updated
06/26/2014
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