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1164090528
LUCAS DE JONG
WICHITA, KS
NPI
1164090528
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: KS 94-10748)
Enumeration Date
2021-06-14
Last Update Date
2021-06-14
Business Address
LUCAS DE JONG
1010 N KANSAS ST
WICHITA, KS 67214-3124
Phone number: 316-293-2665
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Mailing Address
LUCAS DE JONG
1010 N KANSAS ST
WICHITA, KS 67214-3124
Phone number:
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