Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 14-02045 | KS |
NPI | 1013223106 |
---|---|
Provider Name | Jennifer Lynne Garcia |
First Address | Wichita, KS 67206-1262 |
Second Address | Wichita, KS 67212-3288 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2010 |
Last Update Date | 06/08/2021 |