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412 Grand Ave Stafford KS 67578-2010 | |
(620) 234-5221 | |
(620) 234-5792 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 412 Grand Ave, Stafford, Kansas |
Authorized Official Name and Position | Francisco Ortiz (CEO) |
Authorized Official Contact | 6202345221 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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412 Grand Ave Po Box 190 Stafford KS 67578-2010 Ph: (620) 234-5221 | 412 Grand Ave Stafford KS 67578-2010 Ph: (620) 234-5221 |
NPI Number | 1215256995 |
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Provider Enumeration Date | 05/20/2010 |
Last Update Date | 01/28/2011 |
Identifier | Type | State | Issuer |
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1215256995 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |