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Old Westport Ent & Allergy, INC

Otolaryngology in Kansas City, MO. Organization (NPI-2).

NPI number1790733012
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1790733012
Entity type
Organization (NPI-2)
Legal business name
Old Westport Ent & Allergy, INC
Organization subpart
No
Enumeration date
May 5, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Y00000X Otolaryngology––Yes

Practice location

1004 Carondelet Dr
Suite 450
Kansas City, MO 64114-4802

Phone 816-942-7200 · Fax 816-942-2767

Mailing address

216 Nw Executive Way
Lees Summit, MO 64063-1841

Phone 816-875-2599 · Fax 816-875-2598

Authorized official

Dee Ann Bowles
Practice Administrator
8168752599

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