| NPI | 1396815338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE P ROSTE Therapist 816-561-2734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MO 2002001700) |
| Additional Taxonomies | 251S00000X (Licence: KS 2227) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |