| NPI | 1629595756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY WARREN Authorized Offical 316-882-5353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2018-03-17 |