MARK IDSTROM

SHAWNEE MISSION, KS
NPI1639264443
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2085R0202X Radiology, Diagnostic Radiology
(Licence: MO  R2J97)
Enumeration Date2006-10-04
Last Update Date2007-07-08
Business Address
-- MARK IDSTROM MD
9100 W 74TH ST
SHAWNEE MISSION, KS 66204-4004
Phone number: 913-676-2310
Mailing Address
-- MARK IDSTROM MD
9212 NIEMAN RD
OVERLAND PARK, KS 66214-1868
Phone number: 913-599-6777
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