| NPI | 1356704472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANNER HANCOCK Member 316-841-7713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX H7558) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 13076) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2018-01-29 |