| NPI | 1538589767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE D BISSON Owner 913-345-9888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 111N00000X Chiropractor |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2014-04-28 |