BRANDY LYNN WALLACE

ANDOVER, KS
NPI1447370416
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: KS  18-00605)
Enumeration Date2007-03-31
Last Update Date2007-07-08
Business Address
-- BRANDY LYNN WALLACE COTA
621 W 21ST ST
ANDOVER, KS 67002-8498
Phone number: 316-733-1349
Mailing Address
-- BRANDY LYNN WALLACE COTA
5334 S VICTORIA CT
WICHITA, KS 67216-2073
Phone number: 316-946-5805
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