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1568589398
JO ELLEN FUENTES
OVERLAND PARK, KS
NPI
1568589398
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: KS THR-587)
Enumeration Date
2007-03-25
Last Update Date
2007-07-08
Business Address
Mrs. JO ELLEN FUENTES LMT
15238 BROADMOOR ST
OVERLAND PARK, KS 66223-3137
Phone number: 816-529-7307
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Mailing Address
Mrs. JO ELLEN FUENTES LMT
8610 STARK AVE
RAYTOWN, MO 64138-3165
Phone number: 816-529-7307
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