| NPI | 1134443237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY VIRGIL MAYPA TADURAN Owner 620-624-2565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: KS 05-34185) |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2010-03-17 |