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1912365792
RICHARD BOMGARDNER
WICHITA, KS
NPI
1912365792
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: KS 24-00424)
Enumeration Date
2016-02-08
Last Update Date
2016-02-08
Business Address
-- RICHARD BOMGARDNER ATC
1845 FAIRMOUNT ST
WICHITA, KS 67260-0016
Phone number: 316-978-5981
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Mailing Address
-- RICHARD BOMGARDNER ATC
3147 N INWOOD ST
WICHITA, KS 67226-2206
Phone number: 316-978-5981
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