| NPI | 1578893137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH L WOLFF Co Owner 816-214-6755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MO 12760) |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2010-01-05 |