| Kccna | |
|
276 Ne Tudor Rd Lees Summit MO 64086-5696 | |
| (816) 524-1700 | |
| (816) 524-1794 |
| Full Name | Kccna |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 276 Ne Tudor Rd, Lees Summit, Missouri |
| Authorized Official Name and Position | Lillie Luellen (OFFICE MANAGER) |
| Authorized Official Contact | 8165241700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kccna 276 Ne Tudor Rd Lees Summit MO 64086-5696 Ph: (816) 524-1700 | Kccna 276 Ne Tudor Rd Lees Summit MO 64086-5696 Ph: (816) 524-1700 |
| NPI Number | 1922040799 |
|---|---|
| Provider Enumeration Date | 06/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922040799 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | () | Primary |
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