| NPI | 1316658495 |
|---|---|
| Doing Business As | KETAMINE CLINIC RX |
| Entity Type | Organization |
| Authorized Contact | ROBERT FANSLER Office Manager 816-678-5969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QI0500X Clinic/Center, Infusion Therapy |
| Enumeration Date | 2022-12-08 |
| Last Update Date | 2022-12-08 |