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Individual

MR. TODD WAYNE GADDIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAT, ATC

Contact information

Practice address
7550 W. VILLAGE CIRCLE, SUITE 1, WICHITA, KS 67205
(316) 838-2020
Mailing address
510 EASTRIDGE ST N, VALLEY CENTER, KS 67147-4710
(316) 755-2165

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-00044
KS

Other

Enumeration date
12/11/2006
Last updated
07/08/2007
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