| NPI | 1215198023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY JEAN MCENTIRE Secrectary Of Corporation 816-347-0064 |
| Organization Subpart ? | |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2008-06-24 |