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1942215462
K PAUL POULOSE
LEAVENWORTH, KS
NPI
1942215462
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2084N0400X Psychiatry & Neurology, Neurology
(Licence: KS Kansas16526)
Enumeration Date
2006-07-31
Last Update Date
2007-07-08
Business Address
-- K PAUL POULOSE
4101 S 4TH ST
LEAVENWORTH, KS 66048-5014
Phone number: 913-682-2000
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Mailing Address
-- K PAUL POULOSE
1216 SANTA FE ST
LEAVENWORTH, KS 66048-4200
Phone number:
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