TANNER CUSICK
Individual Provider (NPI-1)
Active
Physical Therapy Assistant
Provider Information
- NPI Number
1346756863- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 608 N MULBERRY RD, DERBY, KS, 670373532
- Phone
- (316) 202-0996
- Fax
- (316) 202-0997
Specialties & Taxonomies
Physical Therapy Assistant
Primary License: KS #1403327