| NPI | 1205076759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN B. SHAW Co Executive Director 785-242-2991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: KS 06940878) |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2009-02-24 |