ETHAN JACKS

LEAWOOD, KS
NPI1346969425
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: KS  14-03380)
Enumeration Date2022-08-23
Last Update Date2022-08-23
Business Address
ETHAN JACKS PTA
9425 MISSION RD
LEAWOOD, KS 66206-2045
Phone number: 913-381-2100
Mailing Address
ETHAN JACKS PTA
200 W DOUGLAS AVE STE 250
WICHITA, KS 67202-3002
Phone number: 316-263-0003
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