Provider Demographics
NPI:1265744825
Name:WONG-ROBERTSON, KITTY KIT YING (DOM (NM))
Entity type:Individual
Prefix:DR
First Name:KITTY
Middle Name:KIT YING
Last Name:WONG-ROBERTSON
Suffix:
Gender:F
Credentials:DOM (NM)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26822 W 87TH ST S
Mailing Address - Street 2:
Mailing Address - City:VIOLA
Mailing Address - State:KS
Mailing Address - Zip Code:67149-9643
Mailing Address - Country:US
Mailing Address - Phone:316-214-3222
Mailing Address - Fax:
Practice Address - Street 1:101 S IUKA ST
Practice Address - Street 2:
Practice Address - City:PRATT
Practice Address - State:KS
Practice Address - Zip Code:67124-2562
Practice Address - Country:US
Practice Address - Phone:316-214-3222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-11
Last Update Date:2010-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1024171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist