| Freestate | |
|
4723 E Douglas Ave Wichita KS 67218-1012 | |
| (888) 505-1776 | |
| (888) 505-1776 |
| Full Name | Freestate |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 4723 E Douglas Ave, Wichita, Kansas |
| Authorized Official Name and Position | Elisha Yaghmai (PRESIDENT) |
| Authorized Official Contact | 8885051776 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Freestate 4723 E Douglas Ave Wichita KS 67218-1012 Ph: (888) 505-1776 | Freestate 4723 E Douglas Ave Wichita KS 67218-1012 Ph: (888) 505-1776 |
| NPI Number | 1013441930 |
|---|---|
| Provider Enumeration Date | 04/18/2017 |
| Last Update Date | 04/18/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013441930 | NPI | - | NPPES |
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