| NPI | 1952651713 |
|---|---|
| Doing Business As | GRACEMED DODGE FAMILY CLINIC |
| Entity Type | Organization |
| Authorized Contact | VENUS LEE CEO 316-866-2064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2022-02-01 |