NPI | 1225173149 |
---|---|
Entity Type | Organization |
Authorized Contact | RYAN SCOT DAVIS Office Manager 785-341-4569 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C2-0006045) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C2-0006044) |
363A00000X Physician Assistant (Licence: DE C5-00000702) | |
Enumeration Date | 2007-02-20 |
Last Update Date | 2025-09-05 |