Provider Demographics
NPI:1437518727
Name:WILNER, JOY (OT)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:WILNER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5613 WALMER ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-2512
Mailing Address - Country:US
Mailing Address - Phone:913-645-1301
Mailing Address - Fax:
Practice Address - Street 1:5613 WALMER ST
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-2512
Practice Address - Country:US
Practice Address - Phone:913-645-1301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-02388172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist