Individual
SANJAYA P PERERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
649 S CHERRYWOOD CIR, ANDOVER, KS 67002-8948
(316) 708-1950
Mailing address
649 S CHERRYWOOD CIR, ANDOVER, KS 67002-8948
(316) 708-1950
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
K02000264
KS
Other
Enumeration date
10/09/2018
Last updated
10/09/2018
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