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1154757078
JACOB THOMAS BROWNBACK
KANSAS CITY, KS
NPI
1154757078
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: MO 2012021520)
Enumeration Date
2013-09-24
Last Update Date
2013-09-24
Business Address
-- JACOB THOMAS BROWNBACK
4628 LAFAYETTE AVE
KANSAS CITY, KS 66104
Phone number: 913-302-9317
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Mailing Address
-- JACOB THOMAS BROWNBACK
4628 LAFAYETTE AVE
KANSAS CITY, KS 66104-3335
Phone number: 913-302-9317
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