| Organization Name: | PRATT FAMILY PRACTICE LLC |
| NPI Number: | 1346379625 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN WAKON FOWLER (MEDICAL DIRECTOR) |
| Mailing Address: | 203 Watson St Suite 200 Pratt |
| State: | KS US |
| Postal Code: | 671243066 |
| Phone Number: | 6206727422 |
| Fax Number: | 6204501601 |
| NPI Enumeration Date: | 03/05/2007 |
| NPI Last Update Date: | 03/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | 178987 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |