Provider Demographics
NPI:1326706425
Name:GALAWAY, JILL L
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:L
Last Name:GALAWAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2334 S PRESCOTT ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209-3288
Mailing Address - Country:US
Mailing Address - Phone:316-641-8204
Mailing Address - Fax:
Practice Address - Street 1:1315 N WEST ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-4400
Practice Address - Country:US
Practice Address - Phone:316-943-1294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant