SearchKansas363LF0000X

Travis Thibault

NPI 1861990566 · on the registry since 2018 · sole proprietor

Practice

Address
8438 Timber Ridge Dr
De Soto, KS 66018
Phone
(913) 260-9250

Registry record

Primary taxonomy
363LF0000X
363LF0000X
Also registered as
363LF0000X
Licence states on file
MO, KS
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2021-07-27

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Kansas