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1619057791
SEAN-CARLO PROLAGO
WICHITA, KS
NPI
1619057791
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: KS 15-00662)
Enumeration Date
2006-10-16
Last Update Date
2021-03-30
Business Address
SEAN-CARLO PROLAGO PA
4722 W KELLOGG DR
WICHITA, KS 67209-2508
Phone number: 316-440-2565
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Mailing Address
SEAN-CARLO PROLAGO PA
4722 W KELLOGG DR
WICHITA, KS 67209-2508
Phone number: 316-440-2565
Copy
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