AGE REVERSAL TECHNOLOGIES

WICHITA, KS
NPI1841594892
Entity TypeOrganization
Authorized ContactMICHAEL N SHAW
Owner/President
316-640-6253
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: KS  15-00115)
Additional Taxonomies207R00000X Internal Medicine
(Licence: KS  15-00115)
Enumeration Date2011-01-05
Last Update Date2011-09-30
Business Address
AGE REVERSAL TECHNOLOGIES
2600 N WOODLAWN BLVD
WICHITA, KS 67220-2729
Phone number: 316-640-6253
Mailing Address
AGE REVERSAL TECHNOLOGIES
2600 N WOODLAWN BLVD
WICHITA, KS 67220-2729
Phone number: 316-640-6253