| NPI | 1356646830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER BARTALOS Executive Officer 913-568-6998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MO R9779) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care (Licence: MO 2004008628) |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2011-01-14 |