| Organization Name: | CARESPOT OF RAYTOWN (9490 EAST 350 HIGHWAY), LLC |
| NPI Number: | 1508209735 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JON SUNDOCK (CAO & GENERAL COUNSEL) |
| Mailing Address: | 9490 E 350 Raytown |
| State: | MO US |
| Postal Code: | 641336509 |
| Phone Number: | 6156004060 |
| Fax Number: | 6153094624 |
| NPI Enumeration Date: | 04/08/2013 |
| NPI Last Update Date: | 04/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |