| NPI | 1073577292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE MCCORMICK Clinic Administrator 316-462-1050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 05-25073) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2022-11-22 |