is a Specialist in Lees Summit, Missouri. practices all healthcare services and medical treatments related to Specialist. The NPI Number for is 1417909672. The last update date is .
's current location address is 1741 Ne Douglas St, Lees Summit, Missouri. You can contact this provider via phone number 8165549955 and fax number 8165546451. The mailing address for is 1741 Ne Douglas St, Lees Summit, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1741 Ne Douglas St, Lees Summit, Missouri |
| Phone Number | 8165549955 |
| Fax Number | 8165546451 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1417909672 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1741 Ne Douglas St |
|---|---|
| City | Lees Summit |
| State | Missouri (MO) |
| Post Code | 640864703 |
| Phone Number | 8165549955 |
| Fax Number | 8165546451 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | R8174 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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