| NPI | 1184135584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY TRAUTMAN Practice Manager 913-894-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric |
| Additional Taxonomies | 213E00000X Podiatrist |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2020-04-15 |