| NPI | 1174667174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA A WARD Office Manager 913-631-6114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: KS 0423330) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-08-22 |