| NPI | 1679089783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY DALE WARREN Authorized Official 316-882-5353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2018-02-07 |