Provider Demographics
NPI:1518050715
Name:BOOKLESS, DONALD ROBERT (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:ROBERT
Last Name:BOOKLESS
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:KS
Mailing Address - Zip Code:67063-1543
Mailing Address - Country:US
Mailing Address - Phone:620-947-3782
Mailing Address - Fax:620-947-3393
Practice Address - Street 1:415 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:KS
Practice Address - Zip Code:67063-1543
Practice Address - Country:US
Practice Address - Phone:620-947-3782
Practice Address - Fax:620-947-3393
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-00716225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist