| NPI | 1770057911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESIREE ROME Medical Billing Specialist 785-621-1807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2019-01-21 |
| Last Update Date | 2019-01-21 |