NPI | 1053595413 |
---|---|
Entity Type | Organization |
Authorized Contact | SHANE D BISSON Owner/Doctor 913-345-9888 |
Organization Subpart ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
Additional Taxonomies | 111N00000X Chiropractor |
363L00000X Nurse Practitioner | |
Enumeration Date | 2007-12-20 |
Last Update Date | 2017-07-19 |