| NPI | 1043563349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE BURKHART Administrator 316-425-3215 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2018-01-25 |