| NPI | 1649255894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN A KUNKEL Owner 660-826-5960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 113756) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2020-08-22 |