| NPI | 1457303604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE LYNN STASTNY Practice Manager/Owner 816-228-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO R2J77) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2010-04-09 |