Organization Name: | INCONTINENCE AND OSTEOPOROSIS CENTER LLC |
NPI Number: | 1225168206 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTOPHER ROBERTS (OWNER) |
Mailing Address: | 198 Four States Dr Suite 1 Galena |
State: | KS US |
Postal Code: | 667394304 |
Phone Number: | 6207832356 |
Fax Number: | 6207832395 |
NPI Enumeration Date: | 03/07/2007 |
NPI Last Update Date: | 09/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207VG0400X |
License Number: | 106994 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | Gynecology |
Taxonomy Definition: |