| NPI | 1083054266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLUS SCHABEL Owner 620-704-5719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: KS 01-05551) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2021-05-10 |