Individual
MARLYSE L ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2626 N WEBB RD, WICHITA, KS 67226-8110
(316) 636-6100
(316) 636-5813
Mailing address
2626 N WEBB RD, WICHITA, KS 67226-8110
(316) 636-6100
(316) 636-5813
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1501347
KS
Other
Enumeration date
07/30/2010
Last updated
11/15/2011
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