| NPI | 1457671398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE A LABARCA COO 316-268-5161 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2012-04-20 |