Organization Name: | LIFE CENTER CLINIC |
NPI Number: | 1598903874 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHEILA JOANN TOON (OWNER) |
Mailing Address: | 112 E 6th St Larned |
State: | KS US |
Postal Code: | 675503104 |
Phone Number: | 6208042691 |
Fax Number: | |
NPI Enumeration Date: | 01/26/2009 |
NPI Last Update Date: | 01/26/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1300X |
License Number: | 45341 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Multi-Specialty |
Taxonomy Definition: |