Healthcare Provider Details
I. General information
NPI: 1821194390
Provider Name (Legal Business Name): ALLERGY AND ASTHMA CARE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/15/2006
Last Update Date: 09/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10787 NALL AVE SUITE 200
OVERLAND PARK KS
66211-1375
US
IV. Provider business mailing address
10787 NALL AVE SUITE 200
OVERLAND PARK KS
66211-1375
US
V. Phone/Fax
- Phone: 913-491-3300
- Fax: 913-491-0904
- Phone: 913-491-3300
- Fax: 913-491-0904
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROCHELLE
NEIBURGER
Title or Position: OFFICE MANAGER
Credential: PHD
Phone: 913-491-3300