Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 11-01630 | KS |
NPI | 1003030875 |
---|---|
Provider Name | Mrs. Nancy Ann Falkner |
First Address | Gardner, KS 66030-1406 |
Second Address | Ottawa, KS 66067-3537 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 08/07/2007 |