SHANE MARCUS WILSON

OVERLAND PARK, KS
NPI1902440035
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: KS  14-03105)
Enumeration Date2019-11-01
Last Update Date2019-11-01
Business Address
SHANE MARCUS WILSON
10600 MASTIN ST
OVERLAND PARK, KS 66212-5723
Phone number: 913-681-0606
Mailing Address
SHANE MARCUS WILSON
9105 W 87TH TER
OVERLAND PARK, KS 66212-3607
Phone number:
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