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11301 Ash St Leawood KS 66211-1643 | |
| (913) 338-4515 | |
| (913) 338-4606 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 11301 Ash St, Leawood, Kansas |
| Authorized Official Name and Position | Louis D Christifano (PRESIDENT) |
| Authorized Official Contact | 9133384515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 412554 Kansas City MO 64141-2554 Ph: (913) 338-4515 | 11301 Ash St Leawood KS 66211-1643 Ph: (913) 338-4515 |
| NPI Number | 1558452854 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558452854 | NPI | - | NPPES |
| 31297015 | Other | MO | GROUP PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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