Individual
JAMES WESLEY BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1770 S ROCK RD APT 810, WICHITA, KS 67207-5177
(316) 734-4508
Mailing address
1770 S ROCK RD APT 810, WICHITA, KS 67207-5177
(316) 734-4508
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
17-02894
KS
Other
Enumeration date
06/16/2016
Last updated
06/16/2016
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