ADULT AND PEDIATRIC DERMATOLOGY
Organization (NPI-2)
Active
Dermatology
Provider Information
- NPI Number
1609966753- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 4601 W 109TH ST STE 116, OVERLAND PARK, KS, 662111313
- Phone
- (913) 469-1115
- Fax
- (913) 469-9192
Specialties & Taxonomies
Dermatology
Primary License: KS #0422209