| NPI | 1922518042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY DALE WARREN Authorized Official 316-882-5353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2017-10-03 |