| NPI | 1477948073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN LING Fnp 913-851-4369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MO 2015001261) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2015-04-03 |