| NPI | 1013176221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN SUE RANDEL Operator 785-242-6059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: KS 23-21195-021) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2013-03-15 |