| NPI | 1982788568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA SUE MCCRACKEN Owner/Managing Employee 785-890-7658 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2016-01-22 |