| NPI | 1497802896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID BRYANT SHUCK Owner 316-260-3950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: KS 0523677) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-08-22 |