| NPI | 1760486690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNA WOLKEN Clinic Administrator 620-364-5395 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2022-07-21 |