| NPI | 1205120649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY J LOGAN Owner 816-924-9475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2010035953) |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2016-05-05 |