NPI | 1699189043 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY P DAVIS Sole Owner 316-440-7000 |
Organization Subpart ? | No |
Primary Taxonomy | 261QE0800X Clinic/Center, Endoscopy (Licence: KS 04-30240) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-30240) |
Enumeration Date | 2014-06-13 |
Last Update Date | 2014-06-25 |