NPI | 1235996471 |
---|---|
Entity Type | Organization |
Authorized Contact | JACKILYN NICHOLE BARR Physician Owner 620-365-0925 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
Enumeration Date | 2024-03-04 |
Last Update Date | 2024-03-04 |