Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 14-03439 | KS |
NPI | 1013498096 |
---|---|
Provider Name | Lorinda Joy Dodsworth |
First Address | Wichita, KS 67202-3017 |
Second Address | Independence, KS 67301-3511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2018 |
Last Update Date | 27/08/2018 |