Individual
JASON FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
234 W GREENWAY ST, DERBY, KS 67037-2641
(316) 788-6734
(316) 788-4529
Mailing address
234 W GREENWAY ST, DERBY, KS 67037-2641
(316) 788-6734
(316) 788-4529
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-03075
KS
Other
Enumeration date
01/09/2017
Last updated
01/09/2017
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