NPI | 1700151818 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMARA L PETERSON General Pediatrician/Manager 816-525-2800 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MO 2008015364) |
Enumeration Date | 2012-03-21 |
Last Update Date | 2016-04-26 |