MARK WITACZACK

CHANUTE, KS
NPI1104962182
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2085R0202X Radiology, Diagnostic Radiology
(Licence: KS  05-20132)
Enumeration Date2007-01-29
Last Update Date2007-07-08
Business Address
-- MARK WITACZACK DO
629 S PLUMMER
CHANUTE, KS 66720
Phone number: 316-321-5900
Mailing Address
-- MARK WITACZACK DO
PO BOX 662
CHANUTE, KS 66720
Phone number: