| NPI | 1518194513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN R LARSON Clinic Manager 816-792-0775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: MO 004600) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2009-06-17 |