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1477177863
TANNER JORDAN STAAB
WICHITA, KS
NPI
1477177863
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: KS 3572)
Enumeration Date
2020-06-02
Last Update Date
2020-06-18
Business Address
TANNER JORDAN STAAB
3636 N RIDGE RD
WICHITA, KS 67205-1213
Phone number: 316-462-3636
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Mailing Address
TANNER JORDAN STAAB
4060 N REED AVE APT 912
MAIZE, KS 67101-3813
Phone number: 785-259-1516
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