Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | ||
Y | 225XG0600X | Occupational Therapist - Gerontology | 17-1528 | KS |
NPI | 1528711405 |
---|---|
Provider Name | Joseph Thomas Anyasi |
First Address | Wichita, KS 67203-1525 |
Second Address | Wichita, KS 67212-2900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2022 |
Last Update Date | 02/02/2022 |