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1255902623
TIYAMIKE EZALA
OLATHE, KS
NPI
1255902623
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: KS 53-80288-091)
Enumeration Date
2021-07-07
Last Update Date
2021-07-07
Business Address
TIYAMIKE EZALA NP
26061 W 150TH ST
OLATHE, KS 66061-8511
Phone number: 913-292-4410
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Mailing Address
TIYAMIKE EZALA NP
26061 W 150TH ST
OLATHE, KS 66061-8511
Phone number: 913-292-4410
Copy
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