SEAN-CARLO PROLAGO

WICHITA, KS
NPI1619057791
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: KS  15-00662)
Enumeration Date2006-10-16
Last Update Date2021-03-30
Business Address
SEAN-CARLO PROLAGO PA
4722 W KELLOGG DR
WICHITA, KS 67209-2508
Phone number: 316-440-2565
Mailing Address
SEAN-CARLO PROLAGO PA
4722 W KELLOGG DR
WICHITA, KS 67209-2508
Phone number: 316-440-2565
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