| NPI | 1922256072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAROLD ALBERT JOHNSON Owner 816-453-0017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: MO 2007030787) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2008-09-03 |