Individual
LORRETTA A TACKITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
712 N MONROE AVE, SEDGWICK, KS 67135-9492
(316) 772-5185
(316) 772-0396
Mailing address
7625 SW 36TH ST, HALSTEAD, KS 67056-9338
(316) 772-5185
(316) 772-0396
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-02438
KS
Other
Enumeration date
09/15/2006
Last updated
07/08/2007
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