| NPI | 1619426863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOANNA L HALCOMB Practice Administrator 816-716-3059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: VA R6D61) |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2016-09-29 |