| NPI | 1750754610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BACANI MCKENNEY Owner 620-378-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0432682) |
| Enumeration Date | 2015-11-01 |
| Last Update Date | 2015-11-01 |