| NPI | 1164908281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI LARISON Owner 316-448-8339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QP2000X Clinic/Center Physical Therapy | |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2021-01-25 |