| Full Name | |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 730 1st Ter, Lansing, Kansas |
| Authorized Official Name and Position | Kevin Gullett (BUSINESS MANAGER) |
| Authorized Official Contact | 9136841400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
200 N 4th St Po Box 969 Leavenworth KS 66048-1963 Ph: (913) 684-1400 | 730 1st Ter Lansing KS 66043-1704 Ph: (913) 727-1755 |
| NPI Number | 1346373941 |
|---|---|
| Provider Enumeration Date | 03/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346373941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
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