| NPI | 1629356142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA R MAXWELL Owner 816-232-6459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 096655) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2011-08-24 |