| NPI | 1982014205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WILSON CEO 316-304-9450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: KS 0104695) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2014-05-08 |