| NPI | 1942307285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL R SIMMONS Medical Director 620-231-9669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: KS 04-24193) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2012-12-28 |