Healthcare Provider Details

I. General information

NPI: 1154452175
Provider Name (Legal Business Name): SARAH WULFKUHLE OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1151 N ROCK RD
WICHITA KS
67206-1262
US

IV. Provider business mailing address

6913 E KENTFORD CIR
WICHITA KS
67226-1026
US

V. Phone/Fax

Practice location:
  • Phone: 316-634-3693
  • Fax:
Mailing address:
  • Phone: 316-364-3693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberT-00668
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: