| NPI | 1134496193 |
|---|---|
| Doing Business As | WICHITA PAIN ASSOCIATES COSMETIC |
| Entity Type | Organization |
| Authorized Contact | JEFFREY DUANE FENN President 316-258-5955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0424741) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0430440) |
| 363L00000X Nurse Practitioner (Licence: KS 44143) | |
| 207P00000X Emergency Medicine (Licence: KS 04-23263) | |
| Enumeration Date | 2011-11-18 |
| Last Update Date | 2012-12-28 |