K PAUL POULOSE

LEAVENWORTH, KS
NPI1942215462
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2084N0400X Psychiatry & Neurology, Neurology
(Licence: KS  Kansas16526)
Enumeration Date2006-07-31
Last Update Date2007-07-08
Business Address
-- K PAUL POULOSE
4101 S 4TH ST
LEAVENWORTH, KS 66048-5014
Phone number: 913-682-2000
Mailing Address
-- K PAUL POULOSE
1216 SANTA FE ST
LEAVENWORTH, KS 66048-4200
Phone number: