| NPI | 1013646710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE ESPINOSA Director Of Clinical Operations 816-216-7054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2022-06-08 |