| NPI | 1912963067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHAEDRA M MANN Office Manager 316-462-0460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 0422366) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2017-10-05 |