| NPI | 1639855182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSIE ROSS Owner/Authorized Official 816-569-2815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2023-06-27 |