Individual
MALLORY KNOBLAUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16633 W 45TH ST N, COLWICH, KS 67030-9455
(316) 208-6084
Mailing address
16633 W 45TH ST N, COLWICH, KS 67030-9455
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4868
SC
Other
Enumeration date
09/18/2017
Last updated
04/11/2018
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