Provider Demographics
NPI:1306114434
Name:HARMON, WAYNE E (ATC/L)
Entity type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:E
Last Name:HARMON
Suffix:
Gender:M
Credentials:ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15800 W 123RD ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-4922
Mailing Address - Country:US
Mailing Address - Phone:913-707-4402
Mailing Address - Fax:
Practice Address - Street 1:15800 W 123RD ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-4922
Practice Address - Country:US
Practice Address - Phone:913-707-4402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-03
Last Update Date:2011-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-000462255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer