| NPI | 1104540079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIE MICHELLE CLARK Owner 785-209-3779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208000000X Pediatrics | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2025-02-12 |