| NPI | 1225776230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHONETHEVANH LILY GARNAND Administrator 913-744-1599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2022-05-20 |
| Last Update Date | 2022-05-20 |