| NPI | 1710155577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORRIS F WISE Owner 816-333-7885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MO AW4297102) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2008-04-09 |