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1467042754
GLUTALITY PROVIDER GROUP OF KANSAS, PA.
WICHITA, KS
NPI
1467042754
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Entity Type
Organization
Authorized Contact
MARK MITCHELL
Owner
561-678-2026
Organization Subpart ?
No
Primary Taxonomy
207R00000X Internal Medicine
Enumeration Date
2021-01-21
Last Update Date
2021-11-08
Business Address
GLUTALITY PROVIDER GROUP OF KANSAS, PA.
801 E DOUGLAS AVE FL 2
WICHITA, KS 67202-3548
Phone number: 561-678-2026
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Mailing Address
GLUTALITY PROVIDER GROUP OF KANSAS, PA.
401 FAIRWAY DR STE 200
DEERFIELD BEACH, FL 33441-1800
Phone number: 561-678-2026
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