| NPI | 1104857523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA J FRY Clinic Director 816-279-0079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MO 119-3) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2012-04-05 |