| NPI | 1114498698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLINE THALASINOS Office Manager 816-259-5318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2018-12-10 |
| Last Update Date | 2019-05-01 |