Provider Demographics
NPI:1770714560
Name:MISER, PATRICIA ANN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANN
Last Name:MISER
Suffix:
Gender:F
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 1:6416 LONG AVE
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-2566
Mailing Address - Country:US
Mailing Address - Phone:913-205-3380
Mailing Address - Fax:913-268-8849
Practice Address - Street 1:6416 LONG AVE
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66216-2566
Practice Address - Country:US
Practice Address - Phone:913-205-3380
Practice Address - Fax:913-268-8849
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-28
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-02383261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation