Individual
RICHARD BOMGARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1845 FAIRMOUNT ST, WICHITA, KS 67260-0016
(316) 978-5981
(316) 978-5451
Mailing address
3147 N INWOOD ST, WICHITA, KS 67226-2206
(316) 978-5981
(316) 978-5451
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-00424
KS
Other
Enumeration date
02/08/2016
Last updated
02/08/2016
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