| NPI | 1003473554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN BARTA CEO 620-222-6204 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2023-04-25 |