| NPI | 1457642845 |
|---|---|
| Former Legal Business Name | JOHN L. PROFFITT, M.D., P.A. |
| Entity Type | Organization |
| Authorized Contact | JAN-MARIE KROH President 913-764-1125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2011-04-20 |