LUCAS DE JONG

WICHITA, KS
NPI1164090528
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: KS  94-10748)
Enumeration Date2021-06-14
Last Update Date2021-06-14
Business Address
LUCAS DE JONG
1010 N KANSAS ST
WICHITA, KS 67214-3124
Phone number: 316-293-2665
Mailing Address
LUCAS DE JONG
1010 N KANSAS ST
WICHITA, KS 67214-3124
Phone number: