| NPI | 1417591165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON E. STAHL Owner 913-491-3330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QS0132X Clinic/Center, Ophthalmologic Surgery |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2024-01-11 |